allow of its use, thereby relieving in a mechanical way the pressure caused by the weight of the gravid uterus upon the renal circulation. The urine was frequently treated for albumen, and for the first few days the quantity was enormous, the test-tube showing that two-thirds to three-fourths of its contents was albuminous on reaching the boiling point. The bowels were kept well open with occasional doses of cream of tartar and elaterium, with a view of reducing the work of the kidneys. Her diet during this time was a generous and nourishing one. Labor commenced in about thirty days from the time she was taken with convulsions, which terminated very pleasantly in every particular to both mother and child in about two hours from its beginning. Considering the unfavorable circumstance of not being able to see my patient until taken with convulsions, the happy results of treatment adopted, and the short and easy labor, leaving mother and child in excellent condition, it impresses me as being worthy of more than ordinary consideration. The only addition to the treatment was an occasional dose of bromide of potash and hydrate of chloral to secure rest at night. An experience of nearly forty years in the practice of medicine, and the successful treatment of puerperal convulsions when this method was followed; varying, of course, according to condition of patient and indications observed, leads me firmly to believe in its efficacy. There are five important indications to meet. First, to relieve the congested brain and venous system by bloodletting; second, to relieve the oedematous condition usually present, by administering drastic cathartics; third, to neutralize the carbonate of ammonia present in the blood by use of benzoic acid; fourth, to eliminate from the system urea, by the use of colchicum and guaiacum, thereby preventing its decomposition; fifth, knee and chest position, where it can be done, to relieve in a mechanical way the renal circulation.

TETANUS SUCCESSFULLY TREATED WITH STROPHANTHUS. — William W—, aged twenty-three, ballast man at the Penarth Docks, came under my care on Feb. 18th, 1888, suffering from severe burning pains between the shoulders, extending down the spine. Abdomen rigid; spasms of body, chest, arms, thighs, and legs; jaws locked; countenance anxious; face and mouth contracted; pulse quick and wiry; temperature (108°). He was in appearance a well-developed man; height 5ft. 8in. He stated that about three weeks previously he had the nail of the little finger of the left hand torn when at work, from which he suffered severe pain, and believes that it was frostbitten while following his employment (the cause of his illness). Being constipated, I gave him a full dose of white mixture, which he had great difficulty in taking on account of the locked state

of his jaw. I also prescribed a mixture containing large doses of bromide of potash and hyoscyamus, to be taken every hour for some days; and ordered liniments and poultices to be applied to the spine, abdomen, legs, and feet. The urine was dark and scanty, without any deposit. Beef-tea, mutton broth, milk-and-water, and lemonade were given often, as only very small quantities could be taken at a time. No improvement taking place, I was determined to give strophanthus a trial, and for this purpose employed tabloids containing two minims in each; one was given every three hours, it being with difficulty placed in his mouth, and cold water was taken after each tabloid. About the second day after commencing the strophanthus I was pleased to find him decidedly improved. I could open his mouth sufficiently to introduce the mouth of a feeding cup. The spasms of the body, abdomen, and extremities became less frequent, the pulse quiet, and the temperature lower. I then continued the tabloids, gave another aperient, and ordered him, in addition to the beef-tea, broth, etc., corn-flour, custards, bread-and-milk, and breadand-butter, which he commenced to take regularly, and which he had not been able to do for some considerable time previously. The urine was copious and clear. All the symptoms gradually became less. The strophanthus was now given only twice a day, and was soon discontinued. In a fortnight afterwards the man was able to walk and to take his usual food, the jaws being competent to perform their wonted work. He is at the present time quite restored to health, and is following his employment.-W. J. Clapp, M. R. C. S, etc, in Lancet.

ABORTIVE TREATMENT OF HAY FEVER.-Dr. Carl Genth, of Langen Schwalbach, makes a promising suggestion in connection with the therapeutics of hay fever. For the past ten years, a young medical man of his acquaintance has suffered so severely from hay fever, from the beginning of May to the end of June, that his practice has been seriously interfered with. He has tried all kinds of remedies without benefit. Quinine in large quantities alone produced favourable results, but not before symptoms of poisoning presented themselves, including urticaria on each side of the spine, following the course of the chief nerve-branches down the arms and legs, and finally covering the whole body. In many cases of hay fever Dr. Genth found that the first symptom of the disease was acute conjunctivitis and that the symptoms referable to the mucous membrane of the nose, asthma, etc., set in later. This premonitory symp

tom may precede the final outbreak by a fortnight, and perhaps disappear with a change of weather. Upon this observation he builds his therapeutic plan. Since the first phenomena of hay fever manifest themselves in the eye, it is probable that

the cause of the hay fever first attacks the conjunctiva; that under favourable circumstances (heat) it multiplies there; and that it then diffuses itself over the mucous membrane of the respiratory organs, perhaps through the medium of the lacrimal canal.

The condition must therefore be attacked by local treatment, directed to the eyes at the earliest possible date. Dr. Genth chose instillation and bathing of the conjunctiva with sublimate solution, of the strength of 1 in 3,000. The bathing began fourteen days before the appearance of the hay fever, whenever the patient returned home after open-air exercise. He was besides required to keep as cool as possible, and to wear pale blue spectacles. The result of the treatment was that he remained free from his trouble for a length of time. At the end of June slight irritation of the conjunctiva reappeared, which however, could not be compared in intensity with former attacks, and involved no complication. The bathing had not been preformed with sufficient energy. Although the sublimate solution came in contact with

the mucous membranes of the nose or throat but slightly, or perhaps not at all, neither of these organs was attacked, which must have happened if the virus of the hay fever passed into the body through the nose and mouth. In such an exceptional case, it would be simple enough to apply the solution by a nose douche, by garglings, or perhaps even by cautious inhalation.-Br. Med. Jour.

ANTIPYRIN IN NOCTURNAL EMISSIONS.-According to the Vienna correspondent of the British Medical Journal, Dr. Thör, of Bucharest, has given some particulars as to the effect of antipyrin in cases of nocturnal emissions. Lupulin and camphor have been abandoned in such cases. Curschmann states that the sedative effect of lupulin on the genital organs, in spite of all recommendations, was not proved. As to camphor, it has, according to his opinion, no better effect. Fürbringer (Krankheiten der Harn-und Geschlechtsorgane) is of the same opinion. Zeissl still recommends it, as do Purgsz and other writers. The effect of nux vomica, arsenic, and atropine is also often uncertain. Among all the remedies hitherto employed, bromide of potassium or bromide of sodium was the most useful. Diday recommends it to the exclusion of every other drug. Bromide of potassium, from two to five grammes in a glass of water, taken just before going to bed, will, according to his experience, exert a prompt effect and check the pollutions. The prolonged use of the preparations of bromide, however, as is well known, produced an acne-like eruption, and the use of the remedy had, for this reason, often to be discontinued. Dr. Thör states that he has found antipyrin an excellent substitute for the bromides. He gives it in doses of from eight to fifteen grains, to be taken by the patient a short time before going to bed.

In seven cases it had proved very successful, and checked the pollutions. No disagreeable aftereffects were observed. In "neuro-asthenia sexualis," in the sense of Beard, antipyrin could also be used with good results; but the dose had in these cases to be sometimes increased from fifteen to thirty grains a day.—Med. Rec.

HOW OFTEN SHALL WE RE-VACCINATE ?-This is a very difficult question to answer. Some authors hold that one good primary vaccination followed by one good re-vaccination after puberty, quite meets the necessity of the case, and that successive re-vaccinations are worse than useless. Dr. Seaton says: "We cannot draw from the local phenomena of re-vaccination any inferences whatever as to the state in which the re-vaccinated persons were, as to liability to small-pox. Jenner showed that the natural cow-pox might be induced again and again in persons who, being protected against variola by their first attack of cow-pox, could not be variolated either by inoculation or by exposure, as well as that cow-pox might be made to take on those who had had small-pox." While this supports the view that one good re-vaccination would suffice for the time being, the very element of uncertainty proven by the statement of Jenner himself, raises a doubt as to the period over which this protection would remain active and real; for if we cannot draw any conclusions as to the condition of exposedness or non-exposedness to smallpox from the phenomena of re-vaccination, the only test left is that of an attack of small-pox; and while the percentage of deaths from this disease has been shown to be so low in the case of re-vaccinated persons, we may well infer that a periodical re-vaccination would result in a yet lower death-rate. At all events, it would be in the line of prudence to perform this operation thoroughly, say once in ten years. In this connection, it would be well if the State were to pass a law making vaccination and re-vaccination compulsory; requiring the first to be done at a certain age of the infant (say six months), and the latter every ten years thereafter, up to the age of fifty or sixty years, a record of such vaccinations and re-vaccinations to be filed for reference at the office of the repective boards of health. Dr. Morgan, in the Sacramento Med. Times.

THE TREATMENT OF THE MORPHINE HABIT.Most of the disturbances following the withdrawal of morphine appear to be due to inanition from impaired digestive activity, anorexia, vomiting, profuse diarrhoea and obstinate insomnia. If the digestive disorders are prevented or lessened, the danger of the withdrawal of the drug is removed. From personal observation, Kaczorowski (Medycyna, 1887, Nos. 28 and 29) recommends the following: After the sudden withdrawal of mor

phine, opium is to be administered: Tinct. opii, 30 parts; tinct. iodi, 2 parts; twenty drops to be taken every two hours, day and night. The opiate partially takes the place of the withdrawn morphine, and the iodine, as an antiferment, maintains the appetite and makes possible normal and efficient digestion; vomiting and diarrhoea are rare; the symptoms of deprivation are mild and harmless. The dose is gradually reduced to nothing, and the cure is soon complete. Confine ment is not necessary, as the compulsory cure thus forciby effected is not permanent. Constant observation is indispensable, but the psychical influence is not less important. Well-conducted hospitals are best adapted to carry out the treatment, especially in the hands of a patient and reliable female nurse. To prevent the diffusion of the morphine habit. it is necessary that physicians personally make any necessary hypodermatic in jections, and that they abstain therefrom in their own persons.-Centralbl. für klin. Medizin. Med.

News.

JABORANDI IN LABOR.-Having for years noted the fact that parturition does not progress favor ably till diaphoresis occurs, I have for some months past induced this condition, in the early stage of labor, by giving fl. ext. jaborandi (green-the brown has proved worthless in my hands). When called to a case, I order a warm brick to be applied to the feet which are always cold, and then to give one-third of a teaspoonful of fl. ext. jaborandi in half a wine glassful of water, and repeat the dose every half hour until perspiration occurs. It is very seldom that more than two doses are required. The first effect of this medicine on the patient is soothing, she becomes more quiet, and bears her pain with resignation. Upon being questioned the patient often states that her pains do not hurt her as they did. On examination, after diaphoresis occurs, the os will be found dilating rapidly; the soft parts to be in a favorable condition; and in a short time the labor will be satisfactorily terminated. Should the patient appear weak from the sweating, I wipe her face and neck with a dry towel, and give her a tea spoonful of whiskey, or half as much of aromatic spirits of ammonia. Since using the above remedy, I have no occasion to use ether, chloroform, or the forceps. Med. and Surg. Rep.

THE TREATMENT OF TONSILLITIS BY SALICYLATE OF SODIUM -Mr. Charles Graham (in the Practitioner, May, 1888) confirms the testimony of Mr. Hillaby, already given to the readers of the Gazette, as to the value of salicylate of sodium in the treatment of tonsillitis. Mr. Grabham states that he has treated more than one hundred cases of it, and in the great majority speedy resolution has taken place; in most of these cases which went on to

suppuration, the remedy had either not been given early enough or the doses not large enough or given with sufficient frequency. In incipient cases, especially those occurring in gouty or rheumatic persons, the drug acts like a charm. He gives to an adult from 10 to 20 grains every two hours, or 10 grains every hour until relief is afforded, and then the dose is gradually reduced. All astringent gargles are avoided and the patient directed to use hot milk, or, when the breath is very fetid, warm gargles of permanganate of potassium or hyposulphite of sodium. In cases where the patient has had several attacks of the disease small doses do no good at all, and even larger ones sometimes fail. Mr. Graham likewise states that bicarbonate of sodium, in doses of from 10 to 20 grains every two or three hours, appears equal to the salicylate of sodium in subduing the inflammatory action and preventing suppuration, besides being free from the tendency of salicylate of sodium to produce tinnitus, vertigo and deafness.-Therap. Gaz.

THE PREVENTION OF PUERPERAL FEVER.-Dr. Goodell writes to the Medical Standard, that he succeeded at the Preston Retreat in stamping out puerperal fever from its wards by the following procedure: Previous to the birth of a child the vagina was cleansed by a quart of (1 to 2000) mercury bichloride solution. After complete delivery the vagina was again cleansed in the same way. A suppository containing twenty grains of iodoform was slipped into the vagina. A pad of sublimated cotton kept in place by a T bandage, covered the vulva. His hands and those of his assistant were carefully cleansed by soap, warm water and the nail brush and dipped into a (1 to 1000) sublimate solution before each examination. After the introduction of this plan into the Retreat, not only did puerperal fever cease to appear, but ophthalmia neonatorum vanished. Every year, he says, he is called in consultation to see about a dozen women die from puerperal fever, whose lives, he is sure, might have been saved had the foregoing treatment been adopted.-Med. News.

REMEDY FOR COCCYODYNIA AND PRURITUS ANI. -I have, for reasons I do not now care to speak of, regarded this disease as purely neurotic. I have treated it with the Faradic current. One treatment produces immediate relief; a few treatments cure it. Three cells are sufficient; time, five minutes; the frequency of application depends upon the return of pain. The anode is placed over the sacrum and the cathode in the vagina or rectum, or over the sphincter ani muscle. This treatment, so far as I know, is original with myself.

Much has been written of late concerning the treatment of pruritus ani. I desire to add my own suggestion. The best remedy I have ever

found is the galvanic current; the quantity required need not exceed five milliampères; the time of application, five minutes. The relief is immediate, and the application, once or twice daily, is quickly curative. The anode is placed over the perineum, or base of the scrotum, and the cathode against the spincter ani, or, if required, within its grasp, bringing all the pruritic surfaces between the poles. I claim to be the first, so far as I know, to suggest this remedy for the treatment of this disease. I will, ere long, have more to say of it. -Med. and Surg. Rep.

GLYCERIN SUPPOSITORIES FOR HABITUAL CONSTIPATION.-Boas, in the Deutsche medizin. Wochenschr., states that in a large number of cases he. has had good results from the use of glycerin enemata as a purgative; but in some cases, particularly those with hemorrhoids, or in the individuals with an irritable rectal mucous membrane, which readily bleeds, the use of the syringe is no slight objection, so that the injections must be intermitted or entirely refrained from. The use of the syringe is also inconvenient. For these reasons he has had prepared suppositories consisting of capsules containing 16 minims of pure glycerin, which has been used in twenty cases, with the best results. The suppositories have been found to retain their form and efficacy for many weeks. Fifteen to twenty minutes after using one there is a desire to go to stool, but without tenesmus or other discomfort; soon followed, as a rule, by a copious evacuation. The employment of glycerin per rectum seems specially indicated when, with the constipation, there exists gastic disorder. Med. Prog.

A teaspoonful of this preparation is given every half hour until vomiting and diarrhoea have ceased. The first teaspoonful stops the vomiting, and the third or fourth the diarrhoea. In the few cases in which this treatment fails in entirely checking the disease, it gives great relief and prevents complications. From 1884, two hundred and thirtyfour cases, all of which occurred during the months of July, August, and September, were treated by oxide of zinc, and among these only eight deaths were registered, the death rate being thus only 4.7 per 100.-Br. Med. Jour.

PATHOGENY OF PARALYSIS AGITANS.-Many arguments in favor of the view that paralysis agitans is really an organic disease of the spinal cord are adduced by M. Teissier in the Lyon Medical, No. 28. Jacqoud maintained that the muscular tone derived from the nervous energy of the spinal cord was lost, while Grasset held a hypothesis, not easily understood, based on the assumption of a want of power of sustaining a fixed position. A diffuse sclerosis of the lateral columns has been found, in some cases extending up to the vesicular column of Clarke, and into the intermedio-lateral tract. One case of spinal pachymeningitis during life showed characteristic tremors, retropulsion, and psychic troubles. In this instance, fibrous invasions from the thickened meninges were detected here and there in the white columns of the spinal cord. The main conclusion to be drawn, if M. Teissier's observations are exact, seems to be that paralysis agitans is, like chorea, a symptom, and not a disease in itself.-Lancet.

PAINLESS DESTRUCTION OF NEVI.-A. B., aged two years, suffering from a nævus the size of a

shilling, behind the right ear, was, on May 13th, 1887, treated in the following manner for its removal. Having first painted the healthy skin around the circumference of the nævus, for about half an inch, with a coating of collodion flexile, a thick layer of a four per cent. solution of corrosive sublimate was applied on collodion over the On the twenty-fifth, when the collodion was removed, the nævus had entirely disappeared, and nothing remained but a small scab. Dr. Boing was the first to suggest this method of treatment, and my object in publishing this case is to draw attention to so simple, satisfactory and painless a method of treatment.-Brit. Med. Jour.

nævus.

LEAD AND LEAD POISONING.-The soluble lead salts when applied to raw or abraded surfaces combine with the albumen and cover the part with an impenetrable coating, which serves to exclude the air and promote healing. They also constringe the blood vessels and act as sedatives, allaying inflammation. The lead salts are essentially unirritating and never excite congestion. Lead may be absorbed by the skin in sufficient quantity to produce the constitutional symptoms of the drug. Lead salts act as astringents to the mucous membrane of the mouth, and are partly converted into albuminates. In the stomach the same process is continued, but large doses act as irritants and excite vomiting. Probably most of the drug is absorbed by the mucous membrane of the stomach in the form of albuminate. Any portion which escapes absorption acts in the intestines as an astringent and is then converted into sulphide of lead, an insoluble and inert compound.

When lead is absorbed in small quantities for a length of time it produces a train of symptoms to which the term " plumbism" is applied. From the manifold uses of this metal, lead poisoning is a common occurrence. The modes in which it may be introduced in the system are as follows:

Occupations. (a) House painters often suffer from lead poisoning from want of care in washing the hands before taking food. In grinding the carbonate, which is largely used as a basis for paints, the fine particles are often inhaled in sufficient quantity to produce lead poisoning. Sleeping in freshly painted rooms has been known to produce it.

(b) Compositors often suffer from handling the type, type-metal containing lead. (c) Barmen suffer from handling and cleaning pewter pots. (d) Card players suffer from the lead glaze on cards, especially if they moisten the fingers in the mouth in dealing.

2. Articles of Drink.-(a) Water. Drinking water often becomes contaminated with the lead dissolved from lead pipes and the lining of cisterns. Pure water and water containing carbonate of lime, or sulphate of lime, has little or no action

on lead. Carbonic acid indeed acts as a protective by covering the lead with a fine insoluble film of the corbonate Water containing much oxygen, nitrites, nitrates, chlorides, and especially organic matter, acts quickly on lead. Even a very small quantity as little as 1-50 gr. in a gallon may suffice to produce lead poisoning. Water containing 1-20 gr. to the gallon should be rejected as unsafe. (b) Wine is sometimes sweetened with acetate of lead, and has produced lead poisoning. Bottles are sometimes cleaned with shot, and if these are accidentally left in the bottle the wine may become contaminated. (c) Spirits.-Rum stored in leaden tanks on board ship has caused lead poisoning in sailors. (d) Cider made in glazed earthenware vessels may prove injurious. (e) Lemonade and soda-water may produce lead poisoning when patent syphon tops are used. (ƒ) Beer is often contaminated by the lead pipes, and people who take the first glass in the morning are especially sufferers. (g) Tea packed in lead is equally liable to produce lead poisoning.

3. Articles of Food.-(a) Farinaceous foods wrapped in lead are unsafe. (b) Pickles, when the jars or bottles are capped with leaden tops, are very injurious. (c) Loaf sugar sometimes contains lead from the moulds in which the sugar is set, being painted with white lead, a portion being mechanically taken up. (d) Snuff-Snuff may be adulterated with red lead, or may be unsafe from having been wrapped in leaden covers.

4. Medicines.-Lead given medicinally has been known to excite chronic lead poisoning, but it is of comparatively rare occurrence from this cause, and the acetate is often given in five-grain doses, three times a day for weeks, or even months, to check diarrhoea or hæmorrhage, without producing bad effects.

5. Articles of Apparel.-(a) Lead in the lining of hats has produced symptoms of lead poisoning. (b) Brussels lace is often whitened with preparation of lead.

6. Hair Dyes and Cosmetics.-(a) Hair dyes are a constant source of lead poisoning. (b) Cosmetics containing lead have proved injurious to actors, actresses, and professional beauties.

In some cases of well-marked lead poisoning the source of introduction of the poison may not be discovered even after the most careful investigation.

Symptoms.--(a) Blue Line on the Gums.-The blue line is observed at the edge of the gums where they join the teeth. It is one of the first symptoms to appear, and the slowest to disappear. It is always most marked opposite the incisors. It is absent when there are no teeth, and is most marked in people who fail to clean their teeth. Sometimes it extends to the whole of the gums, and even to the contiguous portions of the cheek. It is produced by the sulphuretted hydrogen de