of urine in infants and children, and almost regards it as a specific for the disease. He prefers to give it simply, and to treat separately any conditions of the patients that may require therapeutical aid to correct those states of physical debility which either predispose to incontinence of urine or aggravate its presence. He gives to an infant from one to three years old, five to ten drops; and to a patient from three to ten years, ten to twenty drops every three hours. Few children object to its taste, and it should be continued uninterruptedly for two or three weeks, and resumed if the disease should return, in which case the doses ought to be gradually increased.-Med. Rec.

PUERPERAL ANEMIA, AND ITS TREATMENT WITH ARSENIC. After a brief reference to the literature of the subject, the writer gives in full the history of a case which did well under the plan of treatment indicated. He then continues :-To Bramwell, of Edinburgh, the profession is indebted for pointing out the almost specific action of this drug in certain cases of pernicious anæmia. The statistics collected by Padley a few years ago, show forty-eight cases treated without arsenic, of which forty-two died. Of twenty-two cases treated with arsenic, sixteen recovered, four died, and two improved. Within the past few years, numerous observations have shown the powerful effect of arsenic in certain cases, Unfortunately, we do not yet fully understand why, in some instances, | the drug should be well borne and prove successful, while in others the patient continues in the progressively downward course. That the cases which we group as pernicious anæmia are very varied is now recognized by all writers on the subject. It is not to be expected that when the gastric tubules are atrophied, arsenic can be curative. We need a careful study of those instances in which the drug has proved successful and of those in which it has failed. To judge from therapeutic test alone there must be a very deep-seated difference between the two classes. I know of nothing more remarkable in practical therapeutics, nothing so resembling specific action (unless we except iron in chlorosis and quinine in ague) than the rapid recovery of profound anæmia under this drug. As a rule it is well borne, and should be given, as Bramwell advises, in increasing doses, beginning with five minims, and rising gradually to twenty or thirty, three times a day. Puffiness of the eyelids, adema above the eyebrows, vomiting or diarrhoea, indicate that the drug should be suspended for a time, or the dose reduced. It is interesting to note that the existence of vomiting or diarrhoea does not, however, contraindicate the employment of the medicine, as in the case here reported. These symptoms seemed to improve, for a time at least, when the arsenic was first given. If the Fowler's solution disagrees, arsen

ious acid may be tried. I have known it to be well borne when the liquor arsenicalis disturbed the stomach. The drug may be given hypodermically, but in these instances of profound anæmia the tendency to hæmorrhage is so marked that the punctures may become hæmorrhagic. I have known considerable subcutaneous extravasation follow an injection. The point of the greatest importance is the fact that the medicine must be given in increasing doses, and for prolonged periods. I find practitioners express great surprise when they hear of doses of Fowler's solution, of fifteen, twenty, and twenty-five drops three times a day. There is, I think, but one rule in the matter; give the drug cautiously until physiological effects are produced. The tolerance of the system for arsenic is well known. I have never seen serious consequences from its careful administration. Young persons, as a rule, take it better than adults. In an instance of pernicious anæmia which I reported a few years ago, the patient took twenty minims of Fowler's solution three times a day for weeks, with the most satisfactory results. In post-partum cases recovery is always slow. It may be many It is months before perfect health is restored. well to intermit arsenic for a few weeks; but the drug should be given at intervals for many months, even when the health is apparently re-established, as there is a well-recognized tendency in these cases to relapse.-Prof. Osler, in Bost. Med. and Surg. Jour.

THE DIRECT APPLICATION OF COPAIBA IN GONORRHOEA. Having read, some time ago, a short article by Dr. I. H. Stearns, of Mansfield, Mass., on The Abortive Treatment of Gonorrhoea, in which he advised the direct application of copaiba balsam, I decided to act upon his suggestion. Hence, the first case that presented itself to me was subjected to that treatment. It was a young man, who, six days previously, had been exposed to contagion. On the evening before I saw him he had noticed slight burning on urinating, and the next morning the burning had increased, and a thin, yellowish discharge had appeared. On examination, I found the meatus reddened. I smeared a No. 23 steel bougie with balsam of copaiba and introduced it down as far as the membranous portion of the urethra and allowed it to remain for six or eight minutes. At noon of the same day he noticed that the scalding, on making water, had diminished, and on the following morning there was no trace of a discharge. The second morning I again introduced the balsam smeared bougie. A third application was made on the fourth day, although he considered himself cured. Four or five weeks after he called on me about another matter, and assured me that no symptom of gonorrhoea had appeared since. I have tried the above plan of treatment since in eight cases

of gonorrhoea in the first stage, and in all but one obtained like results. The exceptional case was that of a young man, who insisted upon drinking large quanties of beer and having intercourse with his mistress on the second night after beginning treatment. In gleet I have obtained no beneficial results at all. This I attributed to the fact that, in the majority of cases, a gleet is kept up by a stricture. When the stricture is cured the gleet disappears; all other treatment is but palliative. It seems but natural that copaiba would manifest its curative properties to more advantage when applied directly, than when compelled to travel through the system first; for, when taken by the stomach, the volatile oil passes off by the lungs, while the copaivic acid is excreted by the kidneys. There is usually a slight burning sensation experienced immediately after the passage of the bougie, but this passes off in a few minutes. Of course the ordinary restrictions in eating and drinking must be observed.-Dr. Rively, in Med. Reg.

TUBERCLE BACILLI IN THE SWEAT OF PHTHISICAL PERSONS.-Dr. Eugenio di Mattei reports, in the Archive prio le Scienze Mediche, a number of experiments made to determine the possibility of transmitting tuberculosis through the medium of the sweat. In the first series, in which the sweat was taken from the skin without any precautions, numbers of tubercle bacilli were found. In the second series the author cleaned carefully a portion of the integument, covering it subsequently with a glass to prevent possible contamination from the air, and then examined the sweat excreted on this part. Here no bacilli were found, showing that the micro-organisms found in the first instance were deposited upon the skin from the surrounding atmosphere, and that none passed through the sweat-glands.-Med. Rec.

INCONTINENCE OF URINE IN CHILDREN.-Dr. J. E. Clark, one of Brooklyn's most celebrated physicians, and President of the Medical Board of of St. Peter's Hospital, stated to us recently, that he had been almost universally successful in treating this unfortuuate malady by dilating, once in a while, the urethral canal with the ordinary sound. Our experience has convinced us of the value of this method. Am. Med. Dig.

DR. ESGUIVE, Colonization physician to the ParisLyons-Mediterranean Railway, Bon-Medja, France, March 28, 1887, says: "I tried BROMIDIA (Battle) on two cases of insomnia, which I had already treated for some time, with a mixture of equal parts of bromide of potassium and chloral. I noticed that hypnotic results were produced with much smaller doses of BROMIDIA than of the mixture of bromide and chloral. In a large

Anodyne, Ergot. 6. Cerebral Tumor. Ergot. Potass. Iod. 7. Cinchonism. Bromides, Iodides. 8. Congestive, ac

tive.

9. Congestive, pas

sive.

Acon., Erg., Morph., Pod., Salines.

Aq. ferv., Dig., Potass. Acetat.
Cimicif., Ver. Vir., Sulphur.
Aloin. Cascara, Hg., Nux Vom., Pod.
Potass. Brom., Valerian.

Bryon., Guarana, Nux Vom., Sod.
Salicyl.

Acon., Antipy., Did., Gels., Ver. Vir. Colch., Salicyl.

Antipy., As., Can. Ind., Dig., Gels.
Cascara, Sulphur.

Asaf., Camph., Hyos., Val. of Zn.
Caffeine, Guarana, Bromides.
Bromides, Camph. Monobrom.,
Chloral, Hyos., Pilocarp.
Antip., Brom., Ergot, Glonoin. Men-
thol.

As. et Op., Frigus. Gels.

Am. Mur., Antipy., Gels., Pierot., Viburn.

Ars. et Bell., Gels., Quin., Am. Picr. Bromides, Gels., Guarana, Strych.,

BENJ. EDSON, M.D., in Medical World.

THE CANADA LANCET.

A Monthly Journal of Medical and Surgical Science Criticism and News.

Communications solicited on all Medical and Scientific subjects, and also Reports of Cases occurring in practice. Address, DR. J. L. DAVISON, 12 Charles St., Toronto.

Advertisements inserted on the most liberal terms. All Letters and Remittances to be addressed to DR. C. SHEARD, 320 Jarvis St., Toronto.

AGENTS.-DAWSON BROS., Montreal; J. & A. MCMILLAN, St. John, N.B.; GEO. STREET & Co., 30 Cornhill, London, Eng.; M. H. MAHLER, 23 Rue Richer, Paris.

TORONTO, FEBRUARY, 1889.

The LANCET has the largest circulation of any Medical Journal in Canada.

DIDACTIC LECTURES.

Our valued contemporary, the Canadian Practitioner, in the January number, is "surprised" at the course taken by this journal, in opposing very strongly any reduction in the full course of didactic lectures, now, as we think very wisely, required. by the Medical Council of Ontario, on the principal subjects, primary and final. We would be even more "surprised" could we, for any reason whatever, advocate the slightest abridgment of this very essential part of medical study. Our contemporary asks, "Shall students be compelled to listen twice to the same set of didactic lectures?" We answer without the least hesitation, and we believe that the vast majority of both good students and teachers will endorse our answer, that two courses are not too many on any important subject; and further, we add, that no good tercher gives just the same set of lectures twice. They are, or should be, so modified and improved every year, as to be full of interest. And we venture the opinion, that nine out of every ten lecturers, whose teaching powers amount to anything worthy the name, will bear out the general opinion of teachers and students, that the first course is of far less value to the student than the second, for the first only lets him know how to profit fully by the second course. And that after having attended both he can read at home, and receive clinical instruction at the hospital to advantage, for he

knows how to read with profit, and can understand the cases he sees. We care not how much the practical instruction given is extended-the more of this the better-but we feel convinced, and that from an experience of over sixteen years, actual teaching in Toronto, that any curtailment in the number of lectures now given in all the important subjects, would be a step in the wrong direction. Believing this, we can never advocate the views advanced by our esteemed contemporary, and again repeat, that it would be an evil day for medical education in Canada if such change should by any possiblity be made.

We had almost omitted to correct an error into which the Canadian Practitioner has fallen, in quoting "McGill University" as in favor of reducing didactic lectures to a single course on each subject. We have it on authority, that whatever may have fallen from any individual member of the Faculty, in giving his own views, the Faculty, as such, has not only come to no decision, but has not, as yet, even considered the matter.

H. W. J. suggests that an undiscovered diabete or nflammatory or cystic disorder of the cervix uteri wil. often render a pruritus vulvæ intractable. Barring these important causes, he should try the fifty per cent. ointment of ichthyol with lanoline. Surgeon, presuming there is no gout or uterine disease, recommends a mixture containing sod. bicarb., mag. sulph., and inf. gent., to be taken three times a day in sufficient quantities to keep the bowels moderately open. Also the following lotion, to be applied on linen cloths three or four times a day :-R Liq. plumbi, 1 drachm; pulv. boracis, 3 drachms; zinci. oxid., 2 drachms; glycerine, 2 ounces; water to sixteen ounces. No alcoholic drink to be taken. Mr. Henry Ryley (West Brompton) has during a practice of thirty years found the disease yield to an outward application of the following:-Liq. plumbi, liq. op. sed. (Battey), ung. cetacei, and pure cream from the cow, of each one ounce. The ingredients must be well

mixed and dispensed in a wide-mouthed bottle, to admit the fingers. Mr. J. F. Briscot suggests a systematic examination of the external and internal organs of generation for tinea, animal or vegetable, vascular caruncle, and other possible sources of irritation within the vagina or rectum, and an ex amination of the rectum. Dr. Thursfield (Leamington) asks if cocaine, either as a lotion or an ointment, has been tried. He suggests that the condition of the os and cervix uteri be ascertained, and that coffee be forbidden. Mr. J. C. Balfour (Redbourne) suggests that relief may be obtained by bathing the parts with a solution of boracic acid in water, or a lotion composed of hydrochlorate of morphia, hydrocyanic acid, and water. Bromide of ammonium given at night as a sedative has also been found useful. Mr. H. E. Rowell (East Rudham) suggests, if no cause for the disease can be found, great cleanliness, and a lotion containing glycer. boracis, 2 ounces; water to 6 ounces. also observes that in the 1888 edition of the “Univesal Merdical Sciences" a sitz bath of hot salt water (from one to five per cent.) just before retiring and an ointment of cocaine oleate and lanoline to be applied twice a day, are recommended by Piffard. Mr. Percy Newell (Ipswich) recommends a careful regulation of the diet and the use of vinolia. The following lotion is, he says, recommended by Dr. Atthill, in his work on eases of Women":-Acid. carbol., 20 grains; tinct. opii, 4 drachms; acid hydrocyan. dil., 2 drachms; glycerine, 4 drachms; water to 4 ounces. Mr. J. Wrixon (Watford) says that he has found the following prescription effectual :-Ung, plumb.

He

"Dis

A

hyd. nit. ox., and acid. borac., of each 2 drachms; cocaine (1 to 30), ounce ; ft. ung. This is to be gently rubbed on night and morning for a month, and the parts bathed in a lotion composed of two teaspoonfuls of borax to a pint of cold water. strong infusion of green tea is also useful. R. W. W. suggests a trial of the following lotion :-Liq. ammon. acet., 1 drachm; acid. hydrocyan. dil., 1 drachm; inf. tabaci to 8 ounces. The parts subject to irritation to be bathed two or three times a day. The inf. tabaci to be made by infusing sixty grains of bird's-eye tobacco in boiling water for a quarter of an hour. Ixion recommends vinolia, which, he thinks, will allay the irritation at once. The preparation is said to consist of zinc, antiseptics, etc.

TESTS FOR HYDROCHLORIC ACID IN THE GASTRIC JUICE.

Not long ago we called attention in an editorial note to the fact, then said to be established, that the gastric juice of persons suffering from cancer of the stomach contains no hydrochloric acid. This conclusion was arrived at by many competent observers, especially among the Germans. It has been lately confirmed by M. Labord, Vechaieff, of St. Petersburg, (Jour. de Méd. de Paris) has decided that the absence of the acid in the stomach and œsophagus in cases of cancer is the rule and that its presence is the exception. He used a number of tests, some of which we give, hoping they may prove of value to those of our readers who may be in doubt as to cases of gastric trouble, as well as to the most approved recent methods of testing for Hel.

1. Aqueous solution of tropeoline. This solution, which is yellow, becomes dark cherry-red when in contact with a liquid containing Too part of hydrochloric acid.