tillat., iij; syr. aurantii cort., 3j. Sig.-Tablespoonful every third hour. Picronitrate of Quinia:

M.

B Quiniæ picronitrat., gr. iij ad vj; sacch. alb., gr. viij. M. One powder every two or three hours.-Deutsche Med. Wochens., 1881, No. 16.

A CASE OF PURPURA FOLLOWED BY DIABETES MELLITUS.-Dr. Otto Seifert (Deutsche Med. Wochens., 1881, No. 17) reports the case of a girl of 10 with a healthy family history, who, while convalescing from a light attack of diphtheria, was attacked by purpura coming on in onsets, accompanied by epistaxis. When examined by Dr. Seifert on June 4, for the first time, the purpura had been present four or five days. The patient did not look ill. The cheeks were red, though the face elsewhere was pale. There were a number of well-marked purpuric patches here and there over the face, slight bleeding from the alveolus of a tooth, the right upper canine, which was absent. The body generally was strewn with pin-head to peasized ecchymoses, sometimes grouped together in patches. Physical examination showed the thoracic organs intact. The area of cardiac dulness was, however, somewhat increased. The pulse was full and regular. Temperature normal. The urine was of a dark brownish-black color, containing blood and albumen in quantity.

tient's general health improving. The patient was placed upon meat diet and cared for assiduously in the hospital. Salicylate of sodium was also administered, and, after some drawbacks, in part due to premature departure from the hospital for a period, she was completely restored to health, and has remained so up to the time of reporting.

The two chief points of interest in the case are, first, the occurrence of purpura as a sequela of diphtheria; and, second, the probable occurrence of small hemorrhages into the medulla oblongata,-hemorrhages which, though slight in themselves, probably gave rise to lesions of the nervous tissue at that point of a more permanent character. This would account for the persistence of the diabetes long after the disappearance of the purpuric symptoms.

CONTRIBUTIONS TO THE Knowledge OF HEREDITARY SYPHILIS.-O. Heubner (Cbl. f. Med.; from Virchow's Archiv, Bd. lxxxiv. p. 248) gives a clinical and anatomical analysis of two rare cases of hereditary syphilitic bone-trouble combined with articular and periarticular suppuration. The first case, which was the one most carefully observed, presented at first. the appearance of an ordinary case of hereditary syphilis of slight character. The specific symptoms first began to show themselves at the end of the third month. These partially disappeared under appropriate treatment. Soon after, peculiar rheumatoid articular lesions began to show themselves, which first consisted in ex

Examination of the blood by the microscope showed the relation between the white and red corpuscles to be normal. The latter showed less tendency to form rouleaux than usual. Microscopic examination of the urine showed numerous red blood-corpuscles of normal contour, but pale and slightly swollen. Single white blood-corpuscles were also observed. The stools were dark.

On June 9 the urine when examined was found to contain sugar, the purpura in the mean time growing less marked, the bleeding from the mouth ceasing, and the pa

Multiple purulent collections occurred in the neighborhood of the various diseased bones, and in one joint in addition which had previously escaped. Death took place at the end of the fourth month. Histological examination of the diseased bones showed that peculiar osseous affection first accurately described by Wegner. Heubner points out the comparatively slight increase in the cells involved in comparison to the very marked proliferation of the cartilage-cell columns in the growing portions of the epiphyses, and conceives the process as being not an actively, but a passively, inflammatory one. As regards the connection between the specific bonedisease and the articular and periarticular suppuration, Heubner, in opposition to earlier writers, looks upon the articular disease, not as an immediate result, but as

a relatively rare complication of the epiphyseal affection, the latter affording the predisposition on which the articular trouble is based.

A case of severe pachymeningitis hæmorrhagica developing in an hereditarily syphilitic child at the end of the eleventh week, increasing in severity, and carrying off the patient in its twenty-second week, is regarded by Heubner as syphilitic on the somewhat insufficient ground that a simultaneous skin-trouble disappeared under specific treatment.

ABSCESS OF THE TIBIA-TREPANATION -CURE.-Dr. Heurtaux, of Nantes (Revue de Thérapeutique, 1881, p. 291), gives the case of a woman 43 years of age, enjoying good general health, without scrofulous or syphilitic history, who received a blow on the crest of the left tibia. She felt severe pain at the moment in the bruised spot, and this augmented week by week until her entry into the hospital. On examination there was neither redness nor swelling, but the patient complained greatly of pains, much worse at night, the limb extremely sensitive to the touch, and the pain aggravated by pressure. The general condition remained good. There was, however, a sudden aggravation of the local symptoms,-redness, increase of pain, swelling, extending to the whole limb, including the foot; no fluctuation; insomnia, loss of appetite, pulse 100 to 112. Dr. Heurtaux, having diagnosticated osteo-myelitis of the tibia, performed the following operation. The soft parts were incised to the extent of six or seven centimetres; the periosteum was incised in its turn and then turned back to the right and left; there was no pus found underneath, but the bony surface was roughened. A trephine was applied at the point where the maximum of pain was felt, and a small quantity of phlegmonous pus escaped.

Some days later an abscess formed in the soft parts, which healed rapidly after a single incision. Afterwards new signs of osteo-myelitis of the lower portion of the leg appeared. A second operation, similar to the first, was practised at this point, the results of which were not less happy. The patient was entirely cured.

INTRA-SPLENIC INJECTIONS OF FOWLER'S SOLUTION IN HYPERTROPHY OF THE SPLEEN. -Prof. Mosler, of Greifswald, has treated a chronic enlargement of the spleen by means of parenchymatous injections of

carbolized water and Fowler's solution. The action of the contractile elements of this organ is first to be stimulated by the application of means designed to affect them directly; then, for several hours previous to making the injections of Fowler's solution, poultices of ice are to be applied over the splenic region. In Mosler's opinion, parenchymatous injections produce much more marked effects than the internal use of the same remedies.

Certain precautions must be taken. 1. If the splenic tumor is a hard one, it makes no difference whether or not the hemorrhagic diathesis or extreme anæmia coexists. 2. The preliminary precautions above mentioned should be taken. 3. Fowler's solution is the best medicine to use. ler reports several cases, in one of which benefit was obtained after half a syringe and then a whole syringeful of Fowler's solution had been injected!-Allg. Med. Cent. Zeit.

THE COEXISTENCE OF OVARIAN CYST AND UMBILICAL HERNIA FROM THE POINT OF VIEW OF OVARIOTOMY.-H. Cazin (Cbl. f. Chir., 1881, p. 429; from Bull. Gén, de Therap., Méd. et Chir.) says that the want of observations on the concurrence of umbilical hernia with ovarian cyst induces him to publish two cases, of which the first, that of a woman 72 years of age who died of exhaustion, showed, in addition to a multilocular cyst, firm adhesions of the contained parts in the hernial sac. A second case was that of a woman of 34, who had suffered with an umbilical hernia since her second labor, and in whom an ovarian tumor had appeared after her fourth confinement. After puncture and drainage, a multilocular cyst of the left side, weighing twenty-nine kilogrammes, was removed by abdominal section. Pieces of considerable size were then excised from the walls of the hernial sac, and the abdominal wound was closed. The patient recovered, and subsequently underwent normal confinement. Cazin speaks of the harmlessness of the incision of large portions of the peritoneum, and says that umbilical hernia is no contra-indication for ovariotomy.

SEPARATION OF THE EPIPHYSES IN HEREDITARY SYPHILIS. - Veraguth (Cbl. f. Chir.; from Virchow's Archiv, Bd. lxxxiv. p. 325) says that while Wegner, Waldeyer and Kobner, Charrin and Parrot, place the chief seat of epiphyseal disease in hereditary syphilitic disease in the bones,

and have observed the separation of the epiphyseal portion at the border of the bone, Haab, in 1875, reported two cases in which the separation unquestionably took place in the cartilage itself, and, indeed, proceeded chiefly in its proliferating zone. Veraguth contributes two similar cases, where, in like manner, the rift occurred in the cartilage and not on the Osseous boundary, and was dependent upon a fibrillar division of the basis-substance on the one hand and abnormal proliferation of the cells on the other. Veraguth agrees with Haab in denominating this process chondritis syphilitica.

NEW TREATMENT FOR FISSURE IN ANO. -Dr. Aguilar (Giornale Int. delle Scien. Med., 1880, Fasc. 8; from Siglo Med.), after having spoken of the frequency of this malady and the established methods of treatment, says that there are two elements in it to combat, -the constipation which accompanies and precedes it, and the lesions belonging to it. The former is overcome by podophyllin in doses of five centigrammes taken at night, and emollient and narcotic hip-baths, which relax the muscular fibres of the sphincter and calm the erethism. On the second day of treatment the whole anal orifice, as far as the internal sphincter, is painted, by means of a small feather, with a mixture of one hundred grammes of alcohol and forty-five of chloroform. This operation is repeated twice a day, morning and evening, preceded by a hip-bath. Pain during the application is quite severe, though by no means so great as in other procedures. The history of four cases successfully treated by the above method is appended.

X.

COMPLETE EXTIRPATION OF LARYNX, BASE OF TONGUE, VELUM PALATI, AND TONSILS (Dr. Caselli, Giornale Int. delle Scien. Med., p. 825; from Italia Medica).-The patient was suffering from a "granuloma" (?) which had invaded and diffused itself throughout all the larynx, pharynx, and base of tongue. Here and there there were circumscribed foci of caseous degeneration, and crateriform ulcers existed at the pharynx and base of the tongue. The operation was performed with antiseptic precautions. The hyoid bone was left intact, thus preserving the nerves, arteries, and muscles to the stump of the tongue. The galvano-cautery was used, and an instrument (the writer does not describe it) of the operator's own device subsequently

AMMONIO SULPHATE OF COPPER IN NEURALGIA.-Dr. Féréol again urges the employment of the ammonio-sulphate of copper in stubborn neuralgia, but, to avoid the disagreeable taste of the medicine, he now administers it in bread wafers. His formula is as follows:

B Cupri ammonio-sulphat., gr. 3; Bismuthi subnitratis, gr. iv. M. Enclose in a cachet de pain (bread wafer) for a single dose.

Five of these are to be taken daily while eating. The amount taken daily may be gradually increased to ten doses, care being taken to swallow the powder during a meal or after having swallowed a glass of milk, to avoid the direct action of the salt upon the stomach. Ordinarily patients fail to taste the disagreeable savor of the medicine; at times, however, sickness of the stomach supervenes, so that it must be stopped.-La France Médicale, 1881, vol. ii. p. 41.

THE CONTAGION OF TUBERCULOSIS.-Dr. Bollinger (Giornale delle Scien. Med.; from L'Imparziale) nourished some young pigs with the milk of a tuberculous cow, and, being killed a few months subsequently, they all, with one exception, exhibited pulmonary tuberculosis. In the exceptional case the milk had been boiled before its administration. From these experiments the author concludes that the milk of a cow may possibly, though not probably, be the cause of tuberculosis by absorption in man. Hence it would be better to drink milk of cows previously boiled, and never to use that from an old cow. He considers it safer to use goat's milk, this animal being rarely affected by the disease.

X.

FATTY PLEURISY.-Dr. Debove (Le Réveil Médical, 1881, p. 466) observed the case of a man of 64, who had been ill for three months and who showed symptoms of pleurisy. Puncture was judged necessary. The liquid obtained was almost exclusively composed of oily granules and of scales of cholesterin. It contained only a few pus-globules. Dr. Debove says he has never met with a similar case. He does not consider the presence of cholesterin a proof of involvement of the liver, but thinks the oily material the result of fatty degeneration of the purulent effusion.

tises something else than homœopathy, no honest man can meet him in consultation without smearing his own self-respect. To gain practice by taking advantage of popular ignorance and prejudice, and to ride into wealth upon a lie, is what no upright man can do; and to associate with a man that does this is dishonor.

This, it seems to us, is the whole matter in a nutshell. The general medical profession recognize that neither the doctrine of similars nor that of dissimilars is correct; and the moment any man comes to this conclusion, and honestly acts thereby, he is part of the regular profession, a peer of any. Until then he must occupy the position he now does.

VIVISECTION IN ENGLAND.

allow abler and more experienced men to do at home,-a peculiar form of piety more easily matched in the English Islands than elsewhere. Not long since we met a man in the English Lake district, of a Sunday afternoon, complaining that his hay would be spoiled by the threatening weather of the coming Monday. On our suggesting that he should get it in at once, he was horrified at our impiety, though he was just then spending his Sunday in the public house swilling beer even unto advanced booziness. So the noble Home Secretary's conscience slept in Calcutta, but was as sensitive as a photograph-plate in London.

At the recent International Congress vivisection and bacteria were the lions of the hour; and if speeches, proclamations, resolutions, etc., can affect the British

more or less acquainted with the act which was passed some years since in England for the regulation of vivisection. The law, even under a liberal construction, is calculated to lessen activity on the part of physiologists, but was not in the outset strenuously opposed by some of the leading savants of Great Britain, as it should have been. Indeed, it was looked upon by many as a judicious compromise. But, like most compromises, it has worked evil. In certain high quarters, including, it is whispered, even the sacred precincts of Windsor, all vivisection is considered to be a crime, and under this inspiration

winter is to be looked for. As physicians and scientists we are of course interested in the trials of our brethren across the sea, and in the progress of medicine there as well as here; but we should fail in our shrewdness if we did not draw a moral from their sufferings, namely, to accept for ourselves no compromise, and to see, in the future even more zealously than in the past, that no legislation touching vivisection is allowed, certainly as no legislation is required or is politic.

CHICAGO'S DISGRACE.

more stringent in the granting of licenses, so that at present, except in a very few places, medical scientific research has come to a stand-still in Great Britain. Sir Jos. Fayrer, now Surgeon-General of the Indian Army, and Dr. Lauder Brunton, not long since desired at their own expense to investigate the action of cobra venom, but were refused licenses by the government, which shortly afterwards paid physicians in Calcutta to do work which they would not

shall be considered more honorable to educate a few medical students in America than to furnish a crowd of studentsgood, bad, and indifferent-with diplomas; but that day does not seem to have come yet. The Chicago Medical Times exults, instead of mourns, because last year twelve hundred medical fledglings fluttered into an already burdened world from our Western city. Mayhap it opines that mourning enough will be done in the