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PMC9999808

Contributions to the Pathology, Diagnosis, and Treatment of Angular Curvature of the Spine. By Benjamin Lee, M.D. Philadelphia: J. B. Lippincott & Co. 1867. pp. 129. This little volume is neatly printed, but without an index or table of contents. It is made up of four interesting essays or articles, originally published in the Medical Times, of New' York, and styled as follows:--1st, Initial Gastralgia. 2d, False Views. 3d, Correct Principles. 4th, Ten Type Cases. The author writes in an easy, interesting style; and the work will amply repay a careful perusal. For sale by S. C. Griggs & Co., 41 Lake St. Price $1.25.

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(r) fl 11 d n a I Convention of Delegates from Med. Colleges.--As indicating the importance we attach to the movement for such a convention, we copy, in place of new editorial matter, the following report of our remarks, originally furnished to the Med. and Surg. Reporter, of Philadelphia:-- During the past year the subject of Medical College Organi- zation and Instruction has been discussed with more freedom than usual in some of the leading medical journals of our coun- try, as well as at the last annual meeting of the "American Medical Association." It will be remembered by our readers that, at the meeting just named, a proposition was made to endorse the action of a convention previously held in Cincin- nati, composed of delegates from several medical colleges in the West and North-west, which had recommended a more uniform rate of lecture fees, and the extension of the annual lecture term to six months. The discussion that followed this proposition was participated in by Drs. D. H. Storer, of Bos- ton ; M. B. Wright, of Cincinnati; Worthington Hooker, of New Haven ; N. S. Davis, of Chicago; and others. It was claimed by the last named gentleman that the evils connected with our present system of medical education could not be remedied by simply lengthening the annual lecture terms and adopting any given rate of lecture fees. However proper these measures might be, their influence would not reach the real source of most of the evils of which the Profession complain--namely, the graduation and admission into the ranks of the Profession of young men whose general education, mental discipline, and medical attainments are all extremely defective. These result, not from the rate of lecture fees, or the length of the lecture terms in our medical schools, but from the three following sources: First, the entire absence of {jll provision for securing any standard of preliminary edu- cation before entering upon the study of medicine. Second, the equally entire absence of all provision for securing a proper method and order of progress in the study of medicine itself. And third, the shortness of the lecture terms, and the insufficient means for clinical instruction in many of the schools. He rep- resented the two first as radical faults, entering into the very foundation of our present system of medical college instruction, and vitiating all its practical results. They were violations of the most important principles, universally recognized in all other departments of education, in this and in all other civi- lized countries. If a young man applies for admission to any literary college, or even high school, he is straightway subjected to an examina- tion, sufficient to test his knowledge of the elementary branches of learning. And why? Simply because it is assumed, on the plainest principles of common sense, that a knowledge of the elementary branches is essential to a proper understanding of the higher and more intricate. It is assumed that a knowl- edge of arithmetic, grammer, geography, etc., must prepare the way for the higher mathematics, philosophy, history, rhetoric, etc.; and that a certain degree of mental discipline and habits of study are necessary to enable the student to make adequate advancement in his collegiate course. In our present system of medical education all this is ignored, and whoever presents himself with the required fee is admitted to our medical colleges, without an inquiry as to whether his mind has been disciplined by an hour of previous study, or whether he is capable of constructing two sentences grammati- cally, or not. The absence of any provision for securing a proper method and progressive order of study after entering the medical col- leges, developes evils equally palpable and mischievous. It bewilders the student by crowding daily upon his mind too great a variety of subjects, and by presenting them in a per- fectly heterogeneous order; while it strongly encourages super- ficiality of attainments, and constant efforts to comprehend the practical departments to the neglect of the more elementary. If the faculty of any of our literary colleges should throw their freshmen, sophomore, junior, and senior classes all into one grand class, and undertake to drill them one hour on some study belonging to the freshmen year, the next hour on one belonging to the senior year, the third hour on one belonging to the sophomore year, and so on, all the world would regard them as better fitted for a lunatic -asylum than for teachers of youth. And yet, this would be exactly parallel to what is done, with one exception, in all the medical colleges in our country. The student just commencing his professional study, and not yet familiar with the naked bones of the skeleton, is placed side by side with the one who has studied two, three, or four years, and both listening during each day to lectures on histology, the elements of chemistry, physiology, and materia medica, interspersed with those on the details of practical med- icine, surgery, and obstetrics. The attempt to include an adequate course of instruction in the various branches of medical science, in five or six lectures per day, for sixteen or eighteen weeks, is not much less objec- tionable than the heterogeneous order in which the instruction is given. He stated that nothing short of a full and careful revision of the whole system of Medical College education, could remove the foregoing defects. Such revision should be founded upon the following fundamental propositions:-- 1st. A fair degree of general education and mental discipline is necessary to enable any young man to study medicine under- standingly. 2d. A knowledge of the elementary branches of medicine, such as Anatomy, Physiology, etc., is essential as a preparatory step to the profitable study of Practical Medicine, Surgery, etc. Hence, a successive order of study is as necessary in the study of medicine as in general science. 3rd. The number of Professorships, and the length of the annual term in each college, should be such as to ensure a com- plete discussion or review of all the legitimate branches of med- ical science. To place the system of medical college instruction in our country upon these self-evident propositions would require the universal adoption and enforcement of a reasonable standard of preliminary education for the medical student; the division of the whole subject of medical science into about twelve branches, four of which should be assigned in proper order to each of the three years required for medical study; the requirement of three courses of lectures instead of two, with a thorough examination of the student, at the close of each course, on those branches belonging to each year successively, and an increase of profes- sorships in each college, corresponding with the whole number of branches to be taught, with an annual lecture term of not less than five full calendar months. To perfect and carry into practical operation a revision of our system of medical educa- tion, so important to the honor and usefulness of the profession, requires a free interchange of views and an honest concert of action among those connected with the medical colleges through- out the whole country. It cannot be accomplished by resolving here in this association that the college fees ought to be uni- form, or that the annual lecture terms ought to be five, six, or seven months. The speaker reminded the members of the association that almost every volume of their transactions, for the last sixteen years, contained resolutions of the same import as those now under discussion. If anything of practical value was accom- plished it would hav^ to be done by the college faculties them- selves. He, therefore, moved, as a substitute for the resolu- tions under discussion, the following resolution: "Resolved, That this Association earnestly requests the Medical Colleges of the country, to hold a convention for the purpose of thoroughly revising the present system of Medical College instruction, and that a committee be appointed to aid in carrying this resolution into effect." Public Commencement of Chicago Medical College.-- The commencement exercises of this institution were held on the 4th and 5th of March. The afternoon of the first day was occupied by reading Theses by some of the candidates for graduation, and the public examination of all the candidates in class. At 3 o'clock P. M., of the second day, the college hall was well filled with an appreciative audience. The exercises were opened with prayer by the Rev. Dr. R. M. Hatfield, of Chicago. The President of the Faculty, Prof. N. S. Davis, after stating briefly the peculiarities in the organization of the college, and the important educational advantages they were designed to afford, had the Secretary call the list of junior students who had undergone examinations in those branches of medical science embraced in the junior course, and delivered to each of them a certificate indicating their progress, accom- panied by a few words of earnest exhortation, continued dili- gence and fidelity in the further prosecution of their profes- sional studies. The Secretary then called the list of candidates for gradua- tion as follows: E. F. Baker, John W. Barlow, Thomas S. Bond, Charles E. Crocker, John T. Curtiss, M. T. Didlake, Peter Epler, John G. Fredighe, David J. Hussey, J. W. Hutchinson, Isaac R. Lane, Elmer T. Lawrence, Wm. Martin, Theron Nichols, Henry P. Oggel, Thomas D. Palmer, Wesley Park, J. A. Parmenter, D. Patton, F. A. Richards, Chester Reeder, R. R. Resseque, David Robertston, W. L. Secumb, D. A. Sheffield, E. T. Twin- ing, M. L. Whitman, John Whelan, and the President conferred upon each the degree of Doctor of Medicine, accompanied by an impressive charge in relation to the privileges conferred upon them, and the duties and responsibilities they had assumed. It was then announced that the Honorary Degree of Doctor of Medicine had been conferred upon Drs. D. W. Beebee, of Elizabeth, 111.; Asher Goslin, of Olney, Ill.; Wm. Law, of Shullsburg, Wis.; N. Holton, of Buda, Ill., and Joseph P. Johnston, of Lynnville, Ill. It was also announced that the Committee of the Faculty, to whom had been referred the Inaugural Theses, had awarded the premium for the best Thesis to John G. Fredighe, of Chi- cago, and for the second best to Theron Nichols, of Wisconsin. R. S. Patterson, M.D., Professor of Medical Jurisprudence, was then introduced to the audience, and delivered an appro- priate and highly interesting valedictory address. Notice was given that the Summer Reading and Clinical Term in the College would commence on the second Monday in March and continue until the first Monday in July. The exercises were closed with a benediction by Rev. Dr. Hatfield. In the evening the graduates, students, and alumni of the College, the Faculty, and members of the Chicago Medical So- ciety, enjoyed a very pleasant social entertainment at the resi- dence of the President of the College. Alumni Association.--Under the head of Proceedings of Medical Societies, in this number of the Examiner, will be found an account of the formation of the "Alumni Asso- ciation of Chicago Medical College," with its Constitution and By-Laws. We invite to this the special attention of all the graduates of the college since its organization in 1859, and hope all who are now living will promptly respond to the invi- tation to .become members of the Association. Such an organization not merely tends to perpetuate friend- ship, social intercourse, and unity of filling among the alumni of a common Alma Mater, but it is equally efficient in keeping alive a generous emulation in the pursuit of knowledge, in the attainment of professional eminence, and the maintenance of professional honor. And we can assure the alumni who may unite with the Association, that their Alma Mater will open wide its doors to welcome them at each returning anniversary meeting. AMERICAN MEDICAL ASSOCIATION. OFFICE OF PERMANENT-SECRETARY, WM. B. ATKINSON, M.D., * 215 Spruce St., Philada. The Eighteenth Annual Meeting of the American Medical Association will be held in Cincinnati, on Tuesday, May 7th, 1867, at 11 o'clock A.M. * The following Committees are expected to report:-- On Quarantine, Dr. Wilson Jewell, Pa., Chairman. On Ligature of Subclavian Artery, Dr. Williard Parker, N.Y., Chairman. On Progress of Medical Science, Dr. Jerome C. Smith, N.Y., Chairman. On the Comparative Value of Life in City and Country, Dr. Edward Jarvis, Mass., Chairman. On Drainage and Sewerage of Cities, &c., Dr. Wilson Jewell, Pa., Chairman. On the Use of Plaster of Paris in Surgery, Dr. Jas. L. Little, N.Y., Chairman. On Prize Essays, Dr. F. Donaldson, Md., Chairman. On Medical Education, Dr. S. D. Gross, Pa., Chairman. On Medical Literature, Dr. A. C. Post, N.Y., Chairman. On Instruction in Medical Colleges, Dr. Nathan S. Davis, Ill., Chairman. On Rank of Medical Men in the Army, Dr. D. II. Storer, Mass., Chairman. On Rank of Medical Men in the Navy, Dr. W. M. Wood, U.S.N., Chairman. On Insanity, Dr. Isaac Ray, R.I., Chairman. On American Medical Necrology, Dr. C. C. Cox, Md., Chair- man. On the Causes of Epidemics, Dr. Thomas Antisell, D.C., Chairman. On Compulsory Vaccination, Dr. A. N. Bell, N.Y., Chairman. On Leakage of Gas-Pipes, Dr. J. C. Draper, N.Y., Chairman. On Alcohol and its Relations to Man, Dr. J. R. W. Dunbar, Md., Chairman. On the Various Surgical Operations for the Relief of Defective Vision, Dr. M. A. Pallen, Mo., Chairman. On Local Anaesthesia, Dr. E. Krackowitzer, N.Y., Chairman. On the Influence upon Vision of the Abnormal Conditions of the Muscular Apparatus of the Eye, Dr. II. D. Noyes, N.Y., Chairman. , On the Comparative Merits of the Different Operations for the Extraction of Vesical Calculi, Dr. B. J. Raphael, N.Y., Chairman. On the Therapeutics of Inhalation, Dr. J. Solis Cohen, Pa., Chairman. * On the Deleterious Articles used in Dentistry, Dr. Augustus Mason, Mass., Chairman. On Medical Ethics, Dr. Worthington Hooker, Con., Chairman. On the Climatology and Epidemics of Maine, Dr. J. C. Weston. of New Hampshire, Dr. P. A. Stockpole. Vermont, Dr. Henry Janes. Massachusetts, Dr. Alfred C. Garratt. Rhode Island, Dr. C. W. Parsons. Connecticut, Dr. B. II. Catlin. New York, Dr. E. M. Chapman. New Jersey, Dr. Ezra M. Hunt. Pennsylvania, Dr. D. F. Condie. Delaware, Dr. -- Wood. Maryland, Dr. 0. S. Mahon. Georgia, Dr. Juriah Ilarriss. Missouri, Dr. Geo. Engelman. Alabama, Dr. R. Miller. Texas, Dr. Greensville Dowell. Illinois, Dr. R. C. Hamil. Indiana, Dr. J. F. Hibberd. District of Columbia, Dr. T. Antisell. Iowa, Dr. J. W. II. Baker. Michigan, Dr. Abm. Sager. Ohio, Dr. J. W. Russell. Secretaries of all medical organizations are requested to forward lists of their Delegates as soon as elected, to the Per- manent-Secretary, W. B. ATKINSON. Mortality Report for the Month of February.--The following is the mortuary report of Health Officer Bridges, of this City, for the month ending March 1. The total number of deaths reported is 255, which is a reduction of 44 from the number of deaths last month:-- CAUSES OF DEATH. Accidents,____,,_________________ 6 Asthma,_________________________ 1 Abscess,________________________ 2 Bronchitis,--------------------- 1 Cancer,_________________________ 3 Cold__________________fil_______ 1 'Croup,-------------------------- 8 Consumption,---------------------42 Convulsions,____________________18 Childbed,----------------------- 5 Congestion of Brain,------------ 7 Congestion of Lungs,____________ 2 Delirium Tremens,--------------- 1 Decline,________________________ 2 Diarrhoea,___i__________________ 1 Diphtheria,_____________-_______ 6 Dropsy,_________________________ 9 Dysentery_______________________ 1 Disease of Brain,_______________ 1 Disease of Bowels,-------------- 2 Disease of Heart,_______________ 4 Disease of Liver,--------------- 2 Disease of Lungs,--------------- 2 Disease of Throat,-------------- 1 Epilepsy,_______________________ 1 Erysipelas,--------------------- 2 Fever, Congestive, ----------- 3 Fever, Remittent,_____________ 2 Fever, Scarlet,______________ 14 Fever, Typhoid,-------------- 10 Hydrocephalus,---------------- 4 Inflammation of Bowels,_______ 4 Inflammation of Brain,-------- 5 Inflammation of Lungs,________19 Inflammation of Stomach,______ 1 Inflammation not stated,______ 1 Killed,_______________________ 1 Marasmus,_____________________ 2 Neuralgia,____________________ 1 Old Age,---------------------- 6 Paralysis,____________________ 1 Pneumonia,____________________ 1 Phthisis Pulmonalis,________._ 2 Rheumatism,_______________*___ 1 Stillborn,____________________22 Small-Pox,____________________ 5 Teething,_____________________ 9 Whooping-Cough,_______________ 1 Worms,________________________ 1 Gun shot Wound,--------------- 1 Ulcer,______________________ 1 Unknown,______________________ 6 Total,----------------------------------------------255 Ages of the Deceased.--Under 5 years, 118; over 5 and under 10 years, 17; over 10 and under 20, 10; over 20 and under 30, 35; over 30 and under 40, 31; over 40 and under 50, 16; over 50 and under 60, 8; over 60 and under 70, 10; over 70 and under 80, 6; over 80 and under 90, 2; unknown, 2. Total, 255. NATIVITIES Chicago,____________124 Other States,________39 Canada,______________ 1 England,____________ 12 France,______________ 1 Germany,____________30 Ireland,------------33 Norway,--------------- 3 Nova Scotia,__________ 1 Sweden,_______________ 3 Scotland, __________ 2 Wales,-------------- 1 Unknown,------------ 5 Total,---255 DIVISIONS OF THE CITY. North,.... 67 | South,. 81 | West,...106 | Totai,.. 255 Money Recipts for Examiner, from Feb. 21st to Mar. 22nd.--Drs. J. H. Judson $3, G. P. Martin 3, Brown H. Kimber 3, J. T. Curtiss 3, R. B. Treat 6, D. F. Morrow 6, II. H. Deming 3, Geo. R. Bibb 3, Geo. II. Scott 3, R. S. Addison 6, L. C. White 3, Wm. II. Sommers 3, M. Lindly 6, B. F. Brown 3, J. S. Sherman 3, Asahel Clark 3, S. L. Fuller 6, Jesse H. Foster 17, W. W. Duncan 4, James M. Hutchinson 3, A. A. Dunn 3.25, J. M. Larrabee 3, J. II. Reynolds 3, L. D. Tompkins 10, David B. Trimble 3, Jas. llayton 3, R. J. Patterson 3, Andrew J. Miller 3, J. W. Lawrence 3, E. M. Blackburn 3.

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CHICAGO COLLEGE OF PHARMACY. A very great interest is just now being manifested among the druggists of the City with reference to this still living, but almost forgotten, institution. The College has recently been the recipient of a costly and extensive collection of chemical specimens, the gift of Messrs. Powers & Weightman, the well-known manufacturing chemists of Philadelphia. The inspection of these specimens was made the occasion of. an informal meeting last Wednesday afternoon. From the remarks made by the President, Mr. E. II. Sargent, it appears that, besides chairs, cases for specimens, etc., the College is in possession also of quite a variety of specimens of materia med- ica, to which additions have been promised as soon as the College is in proper condition to receive them. These, with the valuable collection above referred to, constitute an ample basis upon which to build up a cabinet that will be an honor to the name and fame of our City. It is proposed also, to organize a library, to contain the best works on pharmacy and the collateral sciences. It is not con- s dered best to attempt a course of lectures at present, or until the College has become strong enough to make them successful beyond a doubt. The surplus funds will be used in procuring books, specimens, etc. At the conclusion of the President's remarks, Messrs Buck, Sweet, and Ehrman were appointed a committee to nominate officers. The following were reported and elected:-- President--Mr. E. H. Sargent. Vice-Presidents--Messrs George Buck and W. II. Muller. Secretary--Mr. James W. Mill. Treasurer--Mr. J. P. Sharp. Trustees -- Albert E. Ebert, Henry Sweet, John Mr. Ehrman, William Reinbold, and Emil Dreier. M ssrs Whitfield, Ehrman, and Blocki were then ap- pointed ^special committee to secure permanent rooms for the meetings of the College. At this stage of the proceedings, a member of the profession from Leavenworth, Kansas, was in- troduced to the meeting by Mr. Ebert, and, on motion, unani- mously elected an associate member. The large attendance, the enthusiastic and hopeful spirit manifested at this meeting, augur well for the future success of the College. The other large cities of the Union--Philadel- phia, New York, Boston, Baltimore, Cincinnati, and St. Louis-- have their Colleges of Pharmacy. Why not Chicago? Let the druggists of Chicago have regard to their reputation for intelligence and enterprise, and see to it that the impetus thus given to their College does not fail, from any supineness or indifference on their part, to carry it forward to a high position of usefulness and honor. It is to be hoped that not only the druggists of the City, but many, also, throughout the North- west, will feel sufficient interest to identify themselves with the College, either as active or associate members. Copies of the constitution and by-laws can be had on application to the Secretary, James W. Mill, 119 West Adams Street. The regular monthly meeting of the Chicago College of Pharmacy was held on the afternoon of March 4th, 1867, in Room No. 20, Rice's Building, the President, E. H. Sargent, in the chair. A large attendance of members present. The minutes of the previous evening were read and approved. The Committee on Renting Rooms reported that they had secured a desirable suite of rooms in Rice's Block, and that the same would be suitably furnished as soon as possible. On motion, a committee was appointed to prepare a design for certificates of membership to be issued to each member of the College, as provided for in the by-laws. On motion, standing committees were appointed on the pro- gress of Pharmacy and the revision of Pharmacopoeia; and, also, a temporary committee on the solicitation of specimens for the College. The Secretary was on motion instructed to notify the differ- ent organizations throughout the Country of the reorganization of the Chicago College of Pharmacy. * Several contributions to the library were reported by Mr. A. E. Ebert, and a vote of thanks was tendered to him for his donations. M. Ebert read a paper on the preparation of Bibromide of Mercury, and on a substitute for Liebig's food for infants, made from wheat bran. The subject was fully discussed by the members present. The meeting then adjourned to meet on Monday, March 18th, 1867. J. W. MILL, Secretary. Druggists throughout the North<<-west are earnestly invited to become members, and to contribute to the cabinet and library of the College.

PMC9999812

15 0 0 K 41 0 11 PS e s On the Action of Medicines in the System. By Frederick William Headland, M.D., B.A., F.L.S., Fellow of the Royal College of Physicians, etc., etc. Fifth American, from the Fourth London, Edition, revised and enlarged. Philadelphia: Lindsay & Blakiston. 1867. This new edition of a most valuable work is published in good style, on plain, fair type, and contains 431 pages. The former editions have been so long before the profession, and so extensively read, that their merits are well known. The work is worthy of a place in the library of every practicing physi- cian. For sale by W. B. Keen & Co., 148 Lake St. Price $3.

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ARTICLE XIX. THE INTERIOR OF THE URETHRA VIEWED BY A MAGNESIUM LIGHT. By E. ANDREWS, A.M., M.D., Prof, of Surgery in Chicago Med. College. The invention of the endoscope, simultaneously by a French and by a Dublin surgeon, has opened a new field, both in the pathology and treatment of the urethra. The endoscope con- sists of a lamp, a perforated mirror, and an urethral tube. These, when combined, throw a condensed light into the ure- thra, and enable the surgeon to inspect every part of it. One of the important fruits of this instrument is, the discovery that the chronic inflammation remaining after certain cases of gon- orrhoea is granular in its character, and is, in fact, the same disease as granular conjunctivitis, granular laryngitis, and granular inflammation of the cervix uteri. Some months ago, I had an endoscope constructed after the Parisian plan, and used it with some degree of satisfaction; but there is often a deficiency of light in these instruments, render- ing the view unsatisfactory, unless all parts are in perfect order. Seeking to overcome this evil, I one day procured some small magnesium wire, which, when held in the flame of a lamp, burns with a white light, whose brilliancy dazzles like the glare of the sun at noonday. Introducing the endoscope into the urethra of a patient, I caused a friend to insert the wire into the flame of the lamp. The result was to illuminate the urethra magnificently. The mucous membrane, with every little fold or patch of varied color, was as plainly in view as could possibly be desired. It could not have been seen any better, had it been dissected and laid in the sunlight. By gradually with- drawing the tube, the whole of the canal may successively be seen as it collapses across the end of the tube. Seeing the per- fection of this illumination, I have ordered a spring and some small wheel-work attached to the lamp, so that the wire may be made to advance into the flame without the help of an assistant. In this way, no doubt, the difficulty of the illumination will be fully overcome, and the urethra can be inspected almost as easily, and quite as perfectly, as the tongue.

PMC9999815

Watson Abridged: A Synopsis of the Lectures on the Princi- ples and Practice of Physic, delivered at King's College, London. By Thomas Watson, M.D., etc. (Abridged from .the last English Edition,) with a concise but complete Ac- count of the Properties, Uses, Preparations, Doses, etc., of all the Medicines mentioned in these Lectures, and with other valuable additions. By J. J. Meylor, A.M., M.D. Phila- delphia: Published by the Author. 1867. pp. 277. This appears to be a faithful abridgement of Dr. Watson's well-known work on the Practice of Physic. It is printed on small but plain type, and supplied with such marginal headings as to facilitate references to particular topics. The author says, in his preface:--"The principal object that induced the making of this abridgement was, to afford young practitioners, who are often at a loss what to do on their first 'sick call,' and other physicians, whom numerous professional duties prevent from consulting more extended works, a convenient and expe- ditious means of reference in their daily rounds. Another, but no -less important object, was to supply medical students, dur- ing the lecture seasons, with a ready means of reading over the various subjects treated of in his daily lecture by the Professor on Practice."

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grot reding of ALUMNI ASSOCIATION OF CHICAGO MEDICAL COLLEGE. The following correspondence explains itself.--[Ed. *S. A. McWilliams, M.D., Secretary Alumni Association Chi- cago Medical College. My Dear Doctor: Herewith I have the honor of transmitting you the official reports of the preliminary meeting, and of the meeting of organization, of the Alumni Association of the Chi- cago Medical College, together with the Constitution and By- Laws of the Assoaa&'ow as adopted. << I am, Doctor, Your Obed't Serv't, FRANK W. REILLY, M.D. 71 Hanover Street, March 7th, 1867. MINUTES OF A MEETING OF GRADUATES OF THE CHICAGO MEDICAL COLLEGE, HELD AT DR. DAVIS' OFFICE, SATURDAY EVENING, MARCH 2d, 1867. Present--Drs. J. S. Jewell and John M. Woodworth, Faculty Chicago Medical College; Drs. N. W. Webber, John Quirk, Hiram Wanzer, Robert S. Addison, Julien S. Sherman, and Frank W. Reilly. Dr. Jewell briefly explained the object of the meeting to be the organization of the Alumni of the Chicago Medical College into an association for the encouragement of goodfellowship and mutual benefit, the cultivation of a closer intimacy and stronger bonds between the common children of one Alma Mater, and, generally, the advancement of our professional in- terests by a formal union, holding regular meetings, correspon- dence and the other usual agencies of organized bodies. On motion of Dr. Reilly, Dr. Jewell was called to preside over the meeting, and, on Dr. Woodworth's motion, Dr. Reilly was requested to act as Secretary. On taking the chair, Dr. Jewell stated that the views and suggestions of members on the plan of organization, its aim and scope would be in order, and, after a general and informal discussion, Dr. Addison moved a committee be appointed by the Chair to draft a Constitution and By-Laws. The Chairman appointed Drs. Woodworth, Webber, and Sher- man, with instructions to be prepared to report their action at an adjourned meeting. Dr. Jewell presented a draft of Constitution and By-Laws, which, after a reading, was placed in the hands of the above committee. Dr. Jewell called Dr. Sherman to the chair. The Secretary read, by request, the draft of a Constitution and By-Laws prepared by Dr. Woodworth, which draft was also referred to the committee. On motion of Dr. Woodworth, Dr. Jewell was added to the committee on Constitution and By-Laws. On motion, the meeting adjourned to meet in the upper lec- ture-room at the close of the commencement exercises on Tues- day, March 5th. FRANK W. REILLY, M.D., Secretary. MINUTES OF THE MEETING OF ORGANIZATION. Chicago Medical College, Tuesday, March 5th, 1867. J Present--Drs. Jewell and Woodworth, of the Faculty; Drs. Sherman, Webber, Merriman, Quirk, McWilliams, Reilly, Shef- field, Martin, Reckard, Robertson, Patton, Park, Parmenter, Didlake, Crocker, Oggel, Palmer, Nichols, Fredigke, Resse- guie, Buchtel, Twining, Bond, Baker, Hussey, Lane, Eppler, Hutchinson, Bobb. Dr. Jewell called the meeting to order; the Secretary read the minutes of the previous meeting, which were adopted, and the committee on Constitution and By-Laws submitted the fol- lowing:-- CONSTITUTION AND BY-LAWS OF THE ALUMNI ASSOCIATION OF THE CHICAGO MEDICAL COLLEGE. CONSTITUTION. I. This association shall be known as theAlumni Associa- tion of the Chicago Medical College," and include, as members, all ordinary graduates of said college who shall make applica- tion for such purpose to the Secretary in writing* and pay the usual fees to the Treasurer. All persons who have received the honorary or ad eundem degree shall be known as associate members, and shall be en- titled to all the privileges of the association, except the right of voting and holding office. IL The objects of this association shall be to keep 'alive and perpetuate that kindly and cordial feeling which binds us together by reason of our common Alma Mater ; to encourage the interchange of professional experience, and keep alive that ardor among those who are identified with their Alma Mater in attempting to elevate the standard of medical education; and likewise to secure to the institution a record of the professional history of its alumni. To this end, each member will be expected to address a letter to the Secretary on or before the 15th day of February of each year, giving a short history of his professional experience dur- ing the preceding year; and stating at length anything of special interest that may have come under his observation. III. The officers of this association shall be a President and two Vice-Presidents, a Secretary and Treasurer. The officers shall be chosen by ballot, at each regular annual meeting, and shall hold office until their successors are duly elected. IV. Any member may be expelled for cause, or be removed from office, after due hearing, by a two-thirds vote of the mem- bers present, at any regular meeting. V. Every proposition to alter or amend the constitution shall be submitted in writing; a two-thirds vote of the members present being necessary to the adoption of such measure. BY-LAWS. I. The regular annual meeting of this association shall be held on the first Monday in March of each year. Special meetings may be called by the President, or by a Vice-Presi- dent in the absence of the President. II. The President shall preside at all the meetings of the as- sociation, and call such special meetings as he may deem neces- sary, or as he may be requested to call by any five members. Ten members shall constitute a quorum. III. The Vice-President shall perform the duties of the Pres- ident in case of his absence. IV. The Secretary shall keep the records of the association; shall keep a correct list of the members, together with the date of their graduation, and Post-Office addresses. He shall also have charge of the correspondence, and shall make a report, at the annual meeting, of all communications received by him. lie shall likewise collect and act as custodian of all catalogues, pamphlets, etc., relating to the history of the Chicago Medical College, and preserve copies of such original contributions to medical knowledge as may be contributed by members of the association. V. The Treasurer shall have charge of the funds, and pay all bills authorized by a written order of the President, or, in case of his absence, by one of the Vice-Presidents; and shall render a written report at each annual meeting. VI. Every member shall pay into the hands of the Treasurer the sum of one dollar annually. VII. The order of business at meetings shall be as follows:-- Calling roll of members. Reading minutes of previous meeting. Report of committees. Correspondence. Deferred business. New business. Reading and discussion of papers. Address. VIII. The By-Laws may be altered or amended in the same manner as provided for in the Constitution. The Constitution and By-Laws were unanimously adopted, the committee discharged, and, on motion, the meeting resolved it- self into the Alumni Association of the Chicago Medical College. i The Chairman appointed a committee, consisting of Drs. Woodworth, Merriman, and Sheffield, to nominate officers, which committee, after a brief conference, presented the following nominations :-- President--J. S. Jewell, M.D., Professor of Anatomy Chi. Med. College. 1st'Vice-President--S. L. Fuller. M.D., Appleton, Wis. Cd Vice-President--D. J. IIussey, M.D., Cherry Valley, Ill. Secretary--S. A. McWilliams, M.D., Chicago. Treasurer--Julien S. Sherman, M.D., Chicago. On being duly balloted for the above gentlemen were unan- imously elected, and the President, on taking his seat, made a brief address. On motion, it was ordered that the proceedings of the pre- liminary meetings, together with the Constitution and By-Laws, be furnished the Chicago Medical Examiner for publication; and the Secretary was further instructed to issue a formal invi- tation, through the Examiner, to all graduates of the Chicago Medical College, to become members of the Alumni Associa- tion. The President announced that the Constitution and By-Laws would be found at the residence of Dr. Davis, in the evening, awaiting the signatures of members ; and the Treasurer an- nounced his readiness to receive the dues of members forth- with. Adjourned. FRANK W. REILLY, M.D., Sec y Meeting of Organization.

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ARTICLE XVIII. SUSPENDED DEVELOPMENT IN TWIN PREGNAN- CIES. By M. M. EATON, M.D., Peoria, Ill. In the May No. of the Chicago Medical Journal for 1864, Vol. 21, No. 5, page 206, I reported a case that I attended, where a lady was delivered of a foetus of about two months development, about two hours previous to her being delivered of a still-born fully developed child, at full term. The past summer, having had another case of a similar nature, I thought I would report this also, simply to add an item to accumulating experience on the physiology and pathol- ogy of gestation; such cases being of special interest to the pathologist, and not entirely void of interest to the general practitioner. Case II. Was called, August 14, 1866, to attend Mrs. H., living on North A----St. Found her to be about 21 years of age, native of Illinois, in labor with her first child. She stated that she had always enjoyed good health, and she had the appearance of being in perfect health. On making an exami- nation, I discovered the head of the child presenting to the os uteri, which was dilated about 2| inches, with a gristly sub- stance hanging from the os, an inch or more in length. This, by more careful manipulation, I discovered to be the hand and arm of a small foetus. I then made slight traction in the absence of the pain, and the foetus was delivered. It was of the size of a three months foetus, was not decomposed. The funis consisted simply of a slender membrane, without any appearance of bloodvessels. I should state that the amniotic fluid had been previously discharged. The labor now pro- gressed naturally, and a fully developed living girl was de- livered within an hour. The mother recovered without any trouble; the child still lives, a stout and hearty child. Upon delivering the placenta, I could discover no indication of the attachment of the funis of the foetus to the placental surface. I have these two specimens of arrested development carefully preserved in alcohol. Now, the question arises, what caused the suspension of development in one and not in the other of these twins?

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Medical Register of the District of Columbia, for 1867. Em- bracing Notices of the Medical, Benevolent, and Public Insti- tutions of Washington. By J. M. Toner, M.D. Blanch- ard & Mohun, Washington, D.C. 1867. We are indebted to the author for a copy of this neatly exe- cuted and useful little volume. It is a duodecimo of 102 pages, and contains an amount and variety of information, which makes it interesting and valuable to all members of the profes- sion, whether they ever intend to visit Washington or not. The author has certainly exhibited a remarkable amount of industry and skill in selecting and compressing into so small a compass so large a quantity of important and curious historical and statistical information. He deserves the thanks of the profession and a liberal patronage.

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Orthopedics: A Systematic Treatise upon the Prevention and Correction of Deformities. By David Prince, M.D. Phil- adelphia: Lindsay & Blakiston. 1866. In the preceding issue of the Examiner, we mentioned the fact that no copy of this work had been sent to us, but inserted in the same number a notice of its merits, furnished by a friend. Since that .time, we have received a copy from the publishers, and fin^ it an elegant volume of 240 pages, well illustrated with cuts. It is a good, practical, and reliable work, exactly such as every practitioner needs. For sale by W. B. Keen & Co., 148 Lake St. Price $3.00.

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The Science and Practice of Medicine. By William Aitken, M.D., Edin., Prof, of Pathology in the Army Medical School; Corresponding Member of the Royal Imperial Society of Physicians of Vienna; of the Society of Medicine and Natu- ral History of Dresden; and of the Imperial Society of Med- icine of Constantinople; Late Pathologist attached to the Military Hospitals of the British Troops at Scutari; and Formerly Demonstrator of Anatomy in the University of Glasgow. In Two Volumes. From the Fourth London Edi- tion, with Additions, by Meredith Clymer, M.D., Late Professor of the Institutes and Practice of Medicine in the University of New York; Formerly Consulting Physician to the Philadelphia Hospital, etc. Philadelphia: Lindsay & Blakiston. 1866. pp. 2069. On the appearance of the first volume of the American edi- tion of this work, we gave it a brief and commendatory notice. The second volume, comprising no less than 1114 pages, is now received from the American publishers, and completes the work. The two volumes embrace an aggregate of 2069 pages, and present the reader with a very full consideration of the science and practice of medicine as it exists at the present day. The author has not written it for the purpose of supplying a class of students with a text-book as cheaply as possible; nor as a labor-saving machine for indolent practitioners; nor yet because he had any special theories or favorite doctrines of his own to promulgate. The object of the author appears to have been, to present the profession with a full and well-digested summary of practical medicine as represented by the most eminent Brit- ish writers and practitioners, not by any means, however, dis- regarding the medical literature of other countries. The notes and additions by the American editor, Dr. M. Clymer, are numerous and valuable. In the second volume, alone, they amount to over three hundred pages, embracing such topics as Gonorrhoeal Rheumatism, Delirium of Inanition, Epileptiform Neuralgia, Auscultation, Sphygmograph, Chronic Pyaemia, Syphilitic Disease of the Liver, Addison's Disease, Cerebro- Spinal Meningitis, etc., etc. The American publishers have executed their task well, and the work is in all respects worthy of a place in the library of every medical practitioner. For sale by W. B. Keen & Co., 148 Lake St. Price $12.00.

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THE CHICAGO MEDICAL EXAMINER. N. S. DAVIS, M.D., Editor. VOL. VIII. APRIL, 1867. NO. 4. (Original ^mitriMitirro. ARTICLE XVII. REPORT ON THE HISTORY OF MEDICINE. By S. J. YOUNG, M.D., Ch'n Com., Paris, Ill. Read to the Esculapian Society, at the Meeting held at Paris, Ill., May, 1866. The practice of medicine implies the application of science to the cure of diseases and to their prevention; while that of sur- gery, one of its branches, relates to a similar application to the accidents of the human body and all that class of diseases requiring the use of the knife, or those more purely objective-- fractures, dislocations, ulcers, etc. This is our understanding at the present time, arid has been since the increase of knowl- edge entitled it to a science. But, in the early ages of the human family, it could not claim this rank; and whatever medicinal agents were then used were merely from experience, as not even the virtues of the simplest herb or plant could have been known in any other way. It is evident that in all ages agents of one kind or another have been used for the relief of those afflicted from bodily dis- ease or injury, and that some would give more attention to it than others, and would gradually become the doctors or pre- scribers of medicine; and, as the human mind loves mystery, they ftiade up in their agents what they lacked in knowledge-- and the doctor and all he knew was a bundle of unfathomable mystery. In the mysterious department we have not changed, as this class is as much sought after now as ever before, and spiritual and magical doctors -have a lengthened train of fol- lowers, who believe everything they cannot see, and nothing which they can. They avoid the quod erat demonstrandum, and hug to their foolish bosoms the non est demonstrandum. But to this small beginning, one fact has been added to another, one demonstration to another, until a vast structure has been raised up, now almost perfect, to illuminate the world and gladden the human heart. From the depths of the ocean, a tiny insect has built up in increasing labor vast reefs of coral, each brief age having its increase, giving monuments exceeding those of man. The flowing and the ebbing billows of the sea have thrown up, sand by sand, islands which have become the abode of man. Three thousand years ago, and more, the shapeless mass of medicine began to assume form. Ages ante- rior to that, in Egypt and China, it was practiced as an art; and when the inhabitants of Greece were but savages, living in caves and upon acorns, Phoenicia boasted of her Tyre and the arts of civilization, and the banks of the Nile gave to Athens her foundation, and name, and the arts and sciences, and Thebes sprang up from her no less civilized neighbors, the Phoenicians- From revolutions, came this new world, so long the seat of empire in art and science, and all that was great and com- manding. JEsculapius, whether mythical or real, was the representative of the art of medicine, became a god, to whom temples were erected and in which he was -worshipped. The serpent and the cock were second to him--and these figures are still emblems of our art. He lived before the Trojan war; was said to have been the son of Apollo; accompanied the Argonautic expedi- tion, as their physician; and was greatly skilled in the power of medical plants. His knowledge led to his death, for Plato complained that he restored so many to life, that this god (of the infernal regions) had nothing to do, and Aesculapius was killed by Jupiter by a thunderbolt, the forger of which, Cy- clops, was killed by the incensed father, Apollo. This gives the highest evidence of his skill, and is the only instance known where the grave has made this complaint. Unlike our great father, we shall have the credit of giving to the grave all that is due. Human skill has bounds, and life a termination, but to us belongs the duty of giving length to that which might be short, and ease to that which might be painful; and thus far our pro- fession excels all others. It is as much superior to that of law, as human life is of more value than property. Voltaire says, that a good physician is far above the grand of the world, and kindred to divinity. Machaon and Podalirius, sons of JEsculapius, accompanied the Greeks to the Trojan war, as physicians. The former was a skilful surgeon, and devoted his time to the dressing of wounds. The latter was invited to stay a pestilence in the Grecian camp, which had baffled the skill of others. On his return from the war, being shipwrecked, he cured the king's daughter, who had fallen from the house and was insensible, by bleeding her. This is the first recorded case of bleeding being applied to one stunned by a fall. Having cured her, he mar- ried her. Philoctetes was cured of a wound of the foot, by Machaon, and in a manner which would not be discreditable to the surgery of this age. He was placed in a bath and cast into a deep sleep, when the putrified flesh was cut out, was washed with wine, and herbs applied, by which the parts were healed and the hero restored to health. The statement of this fact is evidence of respectable surgical knowledge--precisely what would now be done, in a similar case, by every gentleman of this Society. Pindar states, that 2Esculapius cured ulcers, wounds, fevers, etc., by enchantments, calming potions, incisions, and by ex- ternal applications. This was pretty good eclectic practice, and rather better than that adopted by the mendicant tribe of the present day. It certainly compared favorably with the charms used by the people of Devonshire, England, 150 years ago. Their infallible remedy for sciatica, called "bone shave," was this:--The patient must lie on his back, on the bank of a river or brook, with a straight staff by his side, and must have the following words repeated over him:-- "Bone shave right, "Bone shave straight. "As the water runs by the stave, "Good for bone shave." In the name of the patient repeated. The interval between the two methods is nearly 2000 years, and the former, I think, has the preference. Instinct and experience go hand in hand in the beginning of the healing art. Instinct would lead the feverish to quench thirst with cooling drinks; one with ague, to get warm by fire and covering; to reject food when the stomach would not receive it. And expe- rience would reapply those remedies which had been found efficacious. These fragments were gathered up in the primitive age, and went far towards the development of system. After the death of 2Esculapius, and he had become deified and temples had been erected to his memory, the medical art. passed into the hands of the priests of these temples, who were called AEsculapiades. They purged, and bled, and vomited, and paid great attention to hygiene. Everything was involved in mystery, and nothing pertaining to the plans was revealed, ft was a sacred and secret society, but knowledge was taught to those who desired to become priests. This age continued for nearly 700 years, when the secrecy was broken through and a new and enlightened age came, which was denominated the Philosophic Age. The zEsculapiades still continued to prac- tice and teach medicine in the temples, but the pupils of Pytho- ras and of the Gymnasia went out and practiced, going from house to house, and city to city. The veil of secrecy was removed, and in the philosophic age a more enlightened and substantial foundation was laid. There were public discussions and teachings. This age continued about 200 years, and until the establishment of the Alexandrian library, 320 years before Christ. In this age lived Hippocrates, who wrote extensively upon everything pertaining to medicine, then known. His writings are frequently referred to at the present day, and ex- hibit the character of a student and philosopher, and a great advancement in medicine over the preceding ages. His doc- trines and teachings were founded upon interpretation of the most abstruse subjects, and no facts or doctrines were an- nounced without a reason, no matter how absurd. He had some knowledge of anatomy, physiology, and pathology, and has exercised a greater influence in medicine than any man that has ever lived since or had before. His school at Cos, acquired great reputation, and although the prejudice of the age in which he lived, forbade dissection of the human body, he obtained, from the dissection of animals, a general idea of anatomy, which enabled him to elucidate many of the doctrines he advocated. His doctrine of coction and vital forces, and of critical days or crisis in disease founded upon that, has undergone but few changes, and has received the sanction of the profession to a certain extent, since his time, now more than two thousand years. Whether false or true, it is a widely obtained belief that the vital forces are expended, or become dominant, and lead to life or death on certain days--on the 7th, 14th, 21st, or other days. It is a doctrine which has been taught all of us. It is a doctrine of truth and of nature, for whatever has life, terminates in death, and if three-score years and ten expends the vital forces unaided by disease, and lead to death, the presence of disease may expend them in a few hours, or days, or when the contest between the two are more equally balanced, it seems reasonable that a certain or fixed time will give dominance to one or the other. All expe- rience teaches this. The eruptive diseases are clearly obedient to this law; and while I do not give credence to all that is said of critical days, I yield a belief to the principle, for it is a seal of God impressed upon all living matter. Some now before me have been born since one of the requirements in the medi- cal schools of France was to understand the aphorisms of Hippocrates, and no man can understand them without being enlightened in his profession. To him and his family the science of medicine owes much of its success and usefulness. His published works astonished the world, and made the physi- cal science of man among the most important branches of philosophy. He was great and renowned in his own age, and the habit of calling medicine the art of XEsculapius was gradu- ally lost, and the learned more frequently spoke of it as the science of Hippocrates. So popular did he make the study of medicine that no man was esteemed learned without it; and Plato and Aristotle were not only philosophers, but were emi- nent physicians and naturalists. The latter founded the first known museum of natural history upon earth. He was the protege of Philip, of Macedonia, the most enlightened and munificent of Kings, and when he selected the philosopher and physician as preceptor to his son, Alexander, he sent him, from his camps in Asia, the rarest of animals and plants to enrich the museum. How great this age of heroes, of philosophers, of statesmen, and of physicians ! It was an age of thought, of reason, and of contest of mind, and rises sublimely beautiful above the grosser eras of succeeding ages. From the pupil and philosopher, Alexander rapidly became the king and con- querer, and in all his rapid strides to monarch of the earth, never forgot what was due to the advancement of science, and shortly after his death, a new era dawned upon the world, which to the ancients had a similar influence to the discovery of printing to the moderns. It was the formation of two great libraries--that of Pergamos and Alexandria--the former containing two hundred thousand volumes, and the latter six hundred thousand. These were accessible to all -who sought their accumulated richness, and has conferred immortality on their founders. Their manuscripts were upon Egyptian papy- rus, but a rivalry between them interdicted the exportation of the papyrus from Egypt to Pergamos, and the latter invented the parchment which has since been so extensively used, and upon which our diplomas of the present day are written. Technical or classical name of which is charta pergamia. When the beautiful Cleopatria had conquered Pergamos, she transferred its library to Alexandria, which for a thousand years continued the seat of learning. This great metropolis of medical science, and its medical schools, were to the ancients what the Paris schools are to the moderns. It was here that the Hebrew savans were charged by Philadelphia with the translation of the Bible into Greek, which has been so highly esteemed ever since, and is called the Septuagent. It was from the banks of the Nile that science and learning went to Greece, and the fire of genius died out at its fountain, when its brilliant light illuminated Attica and the world. After long ages its smouldering spark was again kindled in Egypt, which gave to Alexandria a name and rank which long survived the destruc- tion of the kingdom in which it was located. It was here that anatomy was first taught by dissection. It was the great school of medicine for the world. It was here that Galen, a native of Pergamos, and the great physician of Rome studied. Criminals, who were executed, were given for dissection, and prejudice yielded to reason. The Ptolemies were its patrons, and its name was respected and honored in the uttermost ends of the earth. For four hundred years anatomy was taught in this school, and it may be inferred that it gave an immense impetus to medicine. In fact, the practice of that day was about as it was thirty years ago in this country. Bleeding, purging, and sweating were boldly used, and diseases were classified into internal, external, acute, and chronic. The treatment was divided into hygienie, pharmaceutic, and surgi- cal. They gave great attention to symptons, and were re- markably exact in prognosis. Various sects arose at different periods of the Alexandrian school, which gave rise to discus- sions and the general improvement of medicine ; but all, in reality, were based upon the Hippocratic doctrine, which con- sisted in employing such curative means as would be contrary to the generative cause of disease, or to the primitive and essential, to which all the other symptons are connected. When Alexandria fell under the Roman dominion, its schools of medicine lost their character; for anatomy could no longer withstand the Roman respect and prejudice for the dead, and about the second century of the Christian era its dissecting rooms were closed. Hospitals were established about the fourth century, and the first in that holy city where our Savior was crucified, and by a Christian female from Rome. From that to this day, their holy blessings have been felt throughout the Christian world, and the maimed, and the halt, and the blind, have found within their sacred walls a holy rest of peace, which but for Chris- tianity, which but for medicine, and for the charity of woman's heart, would have been forever shut out. But, in the de- struction of the Alexandrian library, in the sixth century, passed away the glory of accumulated ages. For eighteen hundred years it was the great commercial city of the earth. But only for a thousand years from its foundation to its cap- ture by the Saracens was it great in letters. With that event passed away its schools of philosophy, medicine, theology, and astronomy. The glory and empire of Greece and Rome had passed into the hands of the infidel, who, in their turn, con- tributed largely to the cultivation and spread of science and letters, and from the tenth to the thirteenth centuries, during Moorish rule in Spain, its schools at Cordova, Toledo, and Seville, were the resort of all Europe for instruction. They especially cultivated medicine, and had a school of celebrity at Bagdad, where Rhazes gave lectures, and whose name we see frequently quoted in modern works, especially in eruptive dis- eases. We can readily judge how justly great he is reputed, from a few sentences he has left us on the selection of a. physi- cian, and which is worthy of being understood by all : " Study carefully the antecedents of the man to whose care you propose confiding all you hold most dear upon earth ; that is to say, your health, your life, and the health and lives of your wife and children. If the man is dissipating his time in frivolous pleasures; if he cultivates, with too much zeal, the arts that are foreign to his profession, such as music and poetry ; still more, if he is addicted to wine and debauchery, refrain from committing into such hands a trust so precious. He merits your confidence who, having early applied himself to the study of medicine, has sought skilful instructors, and seen much dis- ease ; who has united to the assiduous reading of good authors his personal observations, for it is impossible to see everything and try everything in one's own practice, and the knowledge and experience of a single individual compared to the knowledge and skill of all men of all ages, resembles a slender brook of water that flows by the side of a gteat river." The Arabian physicians made improvements in pathology and therapeutics. They were the first to distinguish eruptive fevers by the external character of the eruption, variola and varicella. They introduced mild purgatives, such as cassia senna and manna, which happily took the place of the more drastic of the ancients. They also gave us the confection of syrups, of distilled waters, of tinc- tures, and compounded many new ointments, pomades, and plasters, for external applications. A little further on, and during the middle ages, when the northern hords had swept away the civilization of the world, and had destroyed empires, kingdoms, and cities, medicine ' again fell into the hands of the priesthood, and continued until it was so abused that the Pope interdicted the practice of the art in about the thirteenth century. For four centuries prior to that, the- healing art was monopolized bv the Jews and priests, and but little advancement was made,, as may be infer- red from the receipt of a priest, sold for the preparation of green frogs for medicinal use. It was a secret-compound, and the vendor boasted of the large price he obtained for it. The priests and Jews stood at the head of the profession, but others of a lower order divided the profits with them. Such creatures as barbers, bath-tenders, and old women ; especially did the barbers take under their charge minor operative surgery. The result of this condition in medicine so lowered it in the esti- mation of those having authority, that they began to make exactions of knowledge upon those who practiced the profes- sion. Medical colleges again came into repute, and were founded at various points throughout Europe. That of Salerno, in Sicily, obtained great reputation. But its epoch of greatest splendor was about the tenth century, when the crusaders of Christian Europe were rushing to the Holy Land. Being located on this great pathway of travel, gave it advantages of giving aid to the sick and wounded which others less favorably situ- ated did not possess, and its healthy and delicious climate made it a desirable resort for kings and knights, and barons, in their crusades. In fact, its reputation drew from all parts of Eu- rope those afflicted with diseases and wounds difficult of cure. The son of William the Conqueror, was treated there for a wound on his return from the crusade. Its faculty issued edicts for the preservation of health, which were sought after and respected by crowned heads. To the king of England they wrote: "If you wish good health, banish despondency and avoid anger. Drink but little wine, eat light suppers, and do not disdain to take some exercise after meals. Do not sleep during the day; (do not retain too long the urine and evacu- ations from the bowels.) By observing these precepts your life will be prolonged." I quote this to show you the charac- ter of this faculty, and that their advice could not be much improved upon in this day. In the thirteenth century, the king of Naples issued an edict forbidding any one to practice medicine in his kingdom who was not a graduate of the school at Palermo. The require- ments of the scho.ol were a study of three years in logic and five years in medicine. He must have attained the age. of 25 years. He then received a diploma as now. The surgeon was required to devote his time when a student to anatomy, and to prepare himself especially in this department. A new era had now commenced to dawn upon Europe and the world. In the thirteenth century were established most of the universities of Europe. Soon after this the discovery of printing gave a re- newed impetus to learning, and the buried treasures of the Greeks and Romans were brought to light. Knowledge was everywhere sought after, everywhere cultivated, and philoso- phers, statesmen, orators, and physicians, assumed the high rank to which their learning entitled them. We have noticed the primitive period--that of Aesculapius, the priestly period, that of the ASsculapiades, the Hippocratic and Philosophic period, or the Greek period, the schools of Cos, of Pergamos and Alexandria, the Arabic period, the scattering of civilization in the destruction of Greece and Rome, the dark ages, and that of light now dawning upon us--this the great era of the world, this the magnus ab integro soeclorum nascetur ordo. Great advancement had been made in the periods re- cited, both in surgery and in the practice of medicine. Tre- phining is described in all its minutia by Hippocrates, and for hundreds of years was practiced by the JEsculapiades. Even the superior anatomical school of Alexandria added nothing to this operation, and it was almost abandoned by the later Greek and Latin physicians, and ointments and pomades substituted. Nasal polypus was extracted and cauterised by Hippocrates, and the tongue, and the palate, and the tonsils were scarified and cauterized. One of the jEsculapiades even performed tracheotomy. Hippocrates performed the operation of empy- ema, and boldly punctured the chest for collections of pus or serum. The operation, however, fell into disuse afterwards, and was not practiced by the Greek, Latin, or Arabic physi- cians, and in fact was not revived until about the sixteenth century. He practiced paracentesis abdomino--directs that the puncture- must be made near the navel. He did not cut for stone in the bladder, but says he abandoned that operation to the mercenaries who devoted themselves to it, which is signifi- cant that this capital operation was not only known, but prac- ticed in the early age of medical science. This operation was also long abandoned, but was performed by the professors at Alexandria, and by Celsus at Rome, and by itinerants in the middle ages, until it came to be practiced again by the cele- brated surgeon Guy de Chanlias Celsus. Galen and Leonidas, of Alexandria, treated hydrocele by excision, by the seton, cauterization, and puncture. All that our age has done is to add that of stimulating injections. The ancients were close observers of disease, and of all the causes inducing them, such as atmospheric changes, habits, manners, alimentation, and all other causes relating to health and disease, and we are aston- ished that prior to the study of anatomy, they practiced surgery as boldly and successfully as they did. Scarcely a disease now known but that was accurately described by Hippocrates, Celsus, or Galen, and the zeal with which medicine was taught and practiced in the schools of Cos, of Pergamos, and Alex- andria, may justly excite the wonder, and command the admi- ration of all ages and all men. But, upon the revival of letters, and the discovery of printing, and the establishment of medical schools throughout Europe, all that had been taught and known before was taught again, and although the improve- ment was slow, it was upon a sure and more substantial basis. Although they adhered to the doctrines of Hippocrates, Plato, Aristotle, Galen, Rhazes, and Avicenna, in all the schools until about the sixteenth century, still the amphitheatres for dissection and the laboratories of chemistry opened up new avenues of knowledge, which gave increased intelligence and knowledge to the medical world. Necropsy came into practice, and pathology made a beginning to give assurance to observa- tion. Chemistry was rudely known as early as the third cen- tury as alchemy, the only object of wdiich seemed to be change, or attempt the change of the baser metals into gold and silver, but really did not become a science until the last century, since which it has advanced more rapidly, perhaps, than any other branch of our science. It was reserved for the sixteenth century to throw off' adhe- rence to ancient doctrines and dogmas, and to take a rapid and long step in the march of improvement. It wras an age of regeneration in science, and while the torch of physical science was making the world brilliant by the discoveries of Gallileo, by his first calculated laws of gravity, by his discovery of the weight of the atmosphere, and his discovery of the movement of the earth on its own axis, and around the sun; William Harvey discovered the circulation of the blood, and Malpighi, a few years later, in 1661, demonstrated for the first time, by the aid of the microscope, the progression of blood globules in the small vessels; and Hallar and ITelvetius instituted experi- ments to calculate and determine the forces and the manner by which the movements of the chest are affected. About the middle of the same century, lymphatic vessels and their func- tions were discovered by Picquet, which confirmed the doctrine of Harvey and overthrew that of the ancients, which attributed to the liver the functions of hsematosis. Comparative ana- tomy was carefully studied, and the structure of the nervous system better known. About the beginning of the seventeenth century, the celebrated mathematician, Kepler, announced that the chrystaline lense was not, as had been supposed until that time, the seat of vision, but that its function is to refract the rays of light. The researches of Sir Isaac Newton on light and color contributed also to perfect the theory of the visual functions. The organ of hearing and its internal muscles and* minute bones were carefully studied, and Duverney and Vicus- sins, by comparative anatomy, corrected former errors, and established the true seat of audition in the membrane which lines the drum and labarynth. Thomas Willis regarded the brain as an assemblage of various apparatuses, and assigned special functions to some of its divisions, and Camper, by the comparison of heads of men and animals, established the facial angle as the criterian of intellect. Showing that as we descend from the higher to the lower animals, the forehead recedes and the jaws become more elongated. The vital forces attracted attention in this age, and while the mathematicians assumed to explain the functions of the animal economy by the laws of mechanics--that the secretions, the circulation and nutrition, were the result of the elasticity of the tissues and of the friction of liquids; the chemical physician explained it upon the prin- ciple of mixture of chemical elements, of alkalies, acids, gases, salts, and fermentations. But Francis Glisson, an Oxford pro- fessor, overthrew these fallacies by the recognition of irrita- bility as a principle or part of the living solid tissues. In 1757, Haller published his great work on Physiology, and henceforth this branch of our science has held a separate existence from physics or chemistry, and it was demonstrated that life has its laws and its special forces, which require a particular method of study. In the seventeenth century, Ches- elden, the Monroes, and Boerhave, made wonderful advances in surgery, anatomy, and physiology, and in our own-time their works are standard authority. The next century, the eighteenth, presents us with the most brilliant array of names that have ever shone upon the world of medical science. Brown, Cullen, Hunters, the Gregorys, Bichat, Lind, Pringle, and Jenner. Jenner, who has made himself immortal by the introduction of the cow-pox to protect the human family from the dreadful scourge which prior to that annually swept to the grave nearly half a million of the European population, and mutilated and disfigured as many more; Howard, the prison reformer, and Count Rumford, William Thompson, of New * Hampshire, the Bavarian Lieutenant-General and philosopher, who gave bread and labor to the poor bv his improvements, were of this age, and co-workers in medical reform. A long list of other names might be added, which would form a galaxy more brilliant than any the world has ever seen. A division in the various branches of medicine now came into more general use, and men devoted themselves to special departments, and consequently a higher degree of perfection obtained than had hitherto. Abercrombie, upon the Brain; Lsennec, upon Diseases of the Chest; Hunter, upon Anatomy, Surgery, and (Syphilis;) Good, on Practice; Bird, on the Uri- nary Organs; Lawrence, Scarpa, Travers, and Richter, on Operative Surgery, and Diseases of the Eye; Cooper on Sur- gery; Desault and Bichat, the former on Surgery, and the latter upon the Membranes, Life and Death, and upon Anatomy and Physiology. A mere recital of these great names, familiar to us all as household words, sufficiently indicate the progress of medical science in their age. It was the era of intellectual growth and progression. It was the Augustan age of medical science; the crowning glory of all preceding epochs, and the volcanic upheaval of slumbering minds from the womb of time, as the precious metals are thrown up from the deep caverns of earth. Salve magna parens virum. In our own country, we have had Physick, and Rush, and Warren, to represent this age. The present century has not lost the impetus given by the last, and improvements have been made in the pathology and treat- ment of diseases that now impress us as perfect, but which, no doubt, in the future, and in a more advanced stage of medicine, will be found as imperfect as many of the adopted theories and practice of former times, which have yielded to advancement. Since most of those before us have entered the profession, espe- cial improvement has been made in the treatment of diseases peculiar to women; and for this we are indebted to no one so much as to Bennett, whose researches (in uterine pathology) have excelled those of Montgomery and Kennedy, and, in fact, all others. The pathology of inflammation and congestion has in- duced a most wonderful change in the treatment of diseases within the last few years, and the physician can now prescribe with more assurance to himself and satisfaction to his patient. He knows what he does; he travels a plain and well-known road in the bright light of a noonday sun. He discriminates and comprehends the pathological conditions before him, and treats inflammation as such, and congestion as such. When the Hu- moralists and the Solidists contended for supremacy in their respective doctrines, each one attributed all morbid phenomena to his own theory. Now, full credit is yielded to the influence of each and all the parts and elements of the human body--all necessary to life; all suffering, directly or indirectly, in disease. Our researches are conducted with more philosophy. We study by analysis and synthesis. We separate to ultimate and known parts, and again combine in order; study and view all separately, and then combine and study the whole--their action, relation, and dependence one upon the other. Men of sense no longer attribute to a single cause all disease, and to a single medicine a cure for all. The blood has been studied to its ultimate elements. The solids have been studied in like manner; and the action of remedies upon each have been thoroughly tested. But from these various isms light has been shed upon the science. From Homoeopathy the profession has learned to give less medicine, and with greater exactness. From Hydropathy we have learned the value of water, externally and internally. But a few years since, the fevered patient thirsted, but was excluded from drink. In fact, in all ages, God's freest and best gifts, air and water, have been excluded from use to an extent unwarranted by science or common sense. From the Thompsonian doctrine we have learned something of the value of the application of heat and moisture and stimulating applica- tions. Hence, theories and doctrines which seem foolish and and unwise have their agencies to perform in working out good. Even to combat them requires thought and investigation. We have ourselves seen a change in pathology and therapeutical applications in almost every disease. We have witnessed the struggle and supremacy of science over ignorance; all of which has given a large per cent, of the saving of life over former years. The pathology and treatment of every variety of fever, of pneumonia, of dysentery, and, in fact, of nearly every dis- ease, has changed, or undergone great improvement. Watson, and Todd, and Graves, and Bennett, and Parker, Ricord, Stanley, and Williams, and a thousand other glorious names, have given a new era in their respective fields of study and in- vestigation. Genius and learning is concentrated to special departments of our science; that has given a perfection that could not have been expected from universal devotion to the expanded fields, too large for the comprehension of any one mind; too extended for the brief span of life allotted to man. And now, gentlemen, what is the duty devolving upon us? Clearly, it is to commence the great unfinished work of those who have preceded us, and to carry it on to the glory and honor of our profession, and to the welfare and happiness of man- kind. Each one should be vir jxrobus medendi peritus--an honest man instructed in the art of healing. He should be an earnest man with enlarged and catholic views in all that per- tains to learning; in all that pertains to human life, and human disease. He should remember that his own sphere-, whether in the country, the hamlet, or village, requires the same knowl- edge, the same thought, as that of those in the great cities of the earth: for the same complex diseases and accidents are presented foi' his treatment, his investigation, his decision and management, to those. Locality does not change the size of the brain, does not affect thought, but may stimulate it to ac- tion, and excite it to labor. All may enjoy alike the experience and the ideas of all preceding ages, and by reflection and the cultivation of the judgement, may analyze, arrange, and use them to advantage. Practical medicine involves the knowledge of all that is known of the science of medicine, and whether good or bad, depends upon the propel* use of that knowledge. We have yet much to learn, and we should, and may, all be- come investigators, improvers, and teachers. Specific inflam- mation will in all probability be extended beyond its present sphere. That of rheumatism, of syphilis, and variola, may be made applicable to other forms now regarded simple, but differ- ing from them. Hygiene will be improved, an increased knowl- edge of atmospheric influences will aid us in bringing to light causes of disease now unknown. The now hidden mysteries of epidemics will yet be made plain, simple, and appreciable. The bloody war from which we have just emerged has given no less luster to hygiene, alimentation, and the treatment of wounds induced by projectiles of improved character, than it has to the settlement of constitutional liberty. This age is one of progression ; the fire of knowledge is consuming the accu- mulated rubbish of ages, and while the heavens and the earth are lit up by it, let us individually, and as a society, seize upon it, and make it brighter and brighter, until disease shall ac- knowledge our strength and power, and man shall go to the end of his three-score years and ten without its impairment, and shall die alone from expended vital force, and the fiat of'the God who made and controls and governs all things. Havard Medical College.--Dr. James C. White, the tal- ented junior editor of the Boston Medical Surgical Journal, has retired, in order to accept an adjunct professorship of Medical Chemistry, in the Harvard Medical School. Milk Consumed in New York and Vicinity.--The milk consumed in the city of New York and its immediate vicinity, is estimated at an average of three thousands quarts a day. Death of Dr. W. Brinton.--Dr. William Brinton, F.R.S., the distinguished London physician, died of uraemia, on the 18th of January, aged 43 years.

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RESOLUTIONS OF THANKS. Dr. Atlee offered the following:-- Resolved, That the thanks of this Association be presented to the Committee of Arrangements, to the corporate authorities of Cincinnati, to his Honor, Mayor Wilstach, Mr. Geo. II. Pen- dleton, Mr. Larz Anderson, Dr. Geo. Mendenhall, and the cit- izens generally, for the cordial and generous hospitalities ex- tended to the members of the Association during their present session. Dr. Levick, of Philadelphia, remarked upcAi the resolution, saying that no body of men were ever before received with more refined and generous hospitality, and he had been sorry to hear certain remarks deprecating this manifestation of the social element of these meetings. It was an important element in promoting harmony, and, therefore, the dignity of the pro- fession. The resolution was adopted by a unanimous vote. A resolution of thanks to the following named railroads, for commutation of fares, was also passed:--Baltimore & Ohio, Marietta, Little Miami, Columbus & Cleveland, Cincinnati, Hamilton & Dayton, Dayton & Michigan, Cincinnati, Indianap- olis & Lafayette, Covington & Lexington, Chicago & Great Eastern. Dr. Cox remarked, that in presenting the matter in person to the President of the Baltimore & Ohio, that large-minded and liberal-hearted man said, that if a body of politicians, or almost any other class of men, had applied for such a favor, he would most likely have refused them; but that, regarding us as benefactors of the race, he felt happy to contribute what he could to promote our interests and comforts. Dr. Hughes, of Iowa, offered a resolution of thanks to the press of this city, for their full and impartial reports of the proceedings of the Association.

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Death from Chloroform at Bellevue Hospital. -- A death from chloroform took place recently at Bellevue Hos- pital on the occasion of the performance of a rhinoplastic operation by Professor Hamilton. The patient was a robust, middle-aged Irish woman, whose nose had been bitten off in an encounter with an negro. A preliminary operation had been made for the purpose of forming a flap for the new member, and evetything had progressed favorably. The second opera- tion was intended to complete the formation of the nose, but before it could be commenced, the patient expired. It seems that chloroform had been first administered by two of the hos- pital internes with a view of bringing the patient rapidly under the influence of an ansesthetic, and an effort was afterwards made to employ ether, but insensibility not being satisfactorily induced, chloroform was again employed with the desired result, and the anaesthesia afterwards kept up by ether. As the op- erator was about to commence, the patient was noticed to grow suddenly pale, the pulse ceased at the wrist, and despite every exertion to resuscitate her by means, first, of artificial respira- tion, then of the galvanic battery, and afterwards by artificial breathing following laryngotomy, the patient expired. The materials were chemically pure, and the usual care was taken in their administration. Death took place as the result of paralysis of the heart.

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ARTICLE XXV. REPORT ON THE SANITARY CONDITION OF THE CITY, AND THE PREVALENCE OF DISEASES, FROM NOV. 1st, 1866, TO APRIL 1st, 1867. By N. S. DAVIS, M.D., Member of Sanitary Committee. Read to the Chicago Medical Society, April 27th, 1867. In my last report an account of the sanitary condition of the city was given up to the 24th of October, 1866. Up to that date the epidemic, cholera, had continued to pre- vail moderately; but on the 20th of that month the atmosphere had become cool, cloudy, with some rain. On the 21st there fell copious showers, with lightning, and a severe gale of wind from the west. The 22d was cool, nearly clear, with a sharp frost at night; and on the 23d sufficient snow fell to whiten the surface of the ground. From this date the prevalence of cholera declined so rapidly, that after the first of November hardly a single new case was to be found in the city. The month of November was cool, for the most part pleasant, and presented no atmospheric or meteorological peculiarities worthy of note. The prevalence of sickness, and the rate of mortality, were but very little above that of the most healthy seasons, while in October the gross mortality was 1170, of which 673 was from cholera, and 115 from other affections of the bowets; in November the gross mortality was only 382, of which 12 were attributed to cholera, and only 28 to other bowel-affections. The total mortality for the same months in 1865 were: for October 360, and Novem- ber 299. During the months of December, January, February, and March, there was an unusual predominance of steady, mode- rate, cold, and dry weather, with unusually frequent and abun- dant falls of snow. And there was a correspondingly low ratio of sickness and mortality throughout all these months, as shown by the following figures:--Total mortality for December, 309; January, 299; February, 255; March, 280. These rates are below the average mortality of the same months for a series of years. From the subsidence of cholera during the last week of October to the first of April, 1867, no disease of an epidemic character has prevailed in our city. We will, therefore, close our labor as a member of your committee on the sanitary condition of the city for the year ending April 1st, 1867, with a complete statement of the monthly mortality for the year 1866: January,-------------------------------------- 293 February,------------------------------------- 260 March,---------------------------------------- 254 April,________________________________________ 278 May,------------------------------------------ 275 June,----------------------------------------- 319 July,----------------------------------------- 706 August,--------------------------------------- 940 September,------------------------------------ 739 October,------------------------------------- 1170 November,------------------------------------- 382 December,------------------------------------- 309 Total,----------------------------- 5925 Excess of mortality over 1865, 2262, of which 990 were cholera.

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NOTES ON SPANISH SAFFRON. By HENRY BIROTH, of Chicago. Read before the Chicago College of Pharmacy. From some remarks on saffron, at one of our meetings, I have been induced to test its value in regard to purity. I had three samples to dispose of, one from a New York importing house, the others from two Chicago wholesale houses. I was astonished to find them all extensively adulterated. In 100 parts of the saffron, I found In sample No. 1, only 55 parts genuine crocus. In sample No. 2, only 37 " " " In sample No. 3, only 42 " " " the rest were all colored flowers, mostly of marygold or calen- dula officinalis. It is no wonder that saffron is adulterated. It shares the fate of most of our costly imported drugs, such as opium, musk, the essential oils, etc. The test is very simple and interesting. Put a few pieces of saffron on a glass plate, and touch them with concentrated sulphuric acid; the real stigmas assume a beautiful indigo-blue color, while the adulterations remain unchanged. Having experimented in this manner for a little while, you will get so well acquainted with, the genuine saffron that you can readily separate it from the adulterations, with the pincers. The U. S. Dispensatory, in speaking of the tinct. of aloes and myrrh, says:--The saffron, which has been retained in compliance with former prejudices, can add but little to the efficacy of the preparation, and being very expensive, has with great propriety been much reduced in the U. S. formula; and under the head of saffron, it says again:--At present the chief use of the saffron is to impart flavor and color to officinal tinc- tures. This is decisive to us. Now, allow me to ask you why the Pharmacopoea wishes to impose upon us a drug so costly and so much adulterated, merely for the purpose of flavoring and coloring three or four tinctures? Do these tinctures need a coloring substance, being too light without it, or is it neces- sary that they should be flavored? These tinctures are: Acetum opii, tincture of aloes and myrrh, and comp, tinct. of cinchona, w'hich are sufficiently colored and sufficiently aromatic without saffron. We must seek some other reason. Saffron had been extensively used in olden times, and especially by the alchemists, who attributed properties to it which were nearer to superstition than to reality. The passion for gold, the mania of search for the philosopher's stone, the alcahest and the great elixir, or the red tincture, induced them to try almost every- thing; no wonder that saffron, whose tincture shows such a beautiful golden-yellow color, had to play also its part in this drama of development of Alchemistry. Some of these old preparations, which contained saffron, are in use still in our Pharmacopoeas, though greatly changed, of course. The first and most prominent of these is the great pharmaceutical and medical monstrum theriaca, now conf, opii, which will now celebrate its 2000th birthday, Mithridate, of Pontus, 88 A. Ch. being its inventor. It originally consisted of over 100 different drugs, and was always prepared in the City Hall with imposing ceremonies, under the protection of the municipal authorities; it was esteemed as a panacea for all diseases, internally and externally. Then the sacred elixir, now tr. of aloes and rhubarb, the hiera pier a, the elixir of pare- goric of Am. Disp. 1820, the liniment, sapon. camph., according to Gray's Suppl. of Lond. Pharm., the laudanum of Lond. Ph., 1720, the genuine formula of Sydenham's tinct. of opium, the vinum rhei, according to Gray's Suppl., the tincture of rhubarb, London, 1788. All these preparations orginally contained saffron, which in course of time was left out as the formulae were changed more and more. Others retained the saffron as our: Tinct. of Aloes and Myrrh, or the old elix proprietatis para- celsi. Pills of aloes and myrrh, or Rufus Pills. Comp, tinct. of cinchona, or Huxham's elixir. Acetum opii, or the Quaker's black drops. But even with these, it is only a matter of time. Such therapeutists as Alexander, Orfila, and Murray, have proved by experiments that crocus haa but little activity, and the U. S. Dispensatory itself does not consider it a medicinal agent in its preparations, as before stated, merely using it for flavor and color. To-day it is but a mistaken reverence for ancient formulae-- a fear of lifting the veil of mysticism. I do not intend to say that we shall not respect the Pharmaeopoea, or that we shall do as we please, or as we individually think more proper; on the contrary, the Pharmaeopoea shall and must be our rule, our guide in pharmaceutical business, and we must adhere to it in our preparations, until a change is made. And here allow me to testify my high appreciation of the principles inculcated in the excellent essay of Mr. Mill, our Secretary, published in the Proceedings of Am. Ph. Ass., 1865, in which he recommends the utmost fidelity to our national Pharmaeopoea. It is an essay full of ideas, which every young pharmacist, in particular, should observe and study. But, on the other hand, the right of criticism, this solemn right, must not be denied to us, especially in regard to the Pharmaeopoea. Each member should feel himself obliged to speak frankly about anything concerning the pharmaceutical business. Ad astra per aspera.

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AMENDMENTS TO CONSTITUTION. On motion of Dr. Cox, the President was directed to appoint a committee of five, to take into consideration such amendments and alterations in the plan of organization of the Association as may tend to remedy existing defects, and contribute to its efficiency--to report in 1868.

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ARTICLE XXIV. RECOVERY FROM BACKWARD CURVATURE OF THE SPINE--WITH REMOVAL OF THE DEFORMITY. By JULIEN S. SHERMAN, M.D., Chicago. W. H. B., of Chicago, out. 25 years, applied for treatment in Oct. 1866, stating that a year previous he had fallen from a window, injuring his back to such an extent as to confine him to his bed for several months. He recovered sufficiently to be able to partially attend to his business, but on any unusual exertion, pain would return at the seat of injury and oblige him to desist from his labor.. There was slight numbness of the left leg and thigh; pressure upon the shoulders caused pain at the injured spot. On examination of the back, the spinous process of the last dorsal vertebra showed a decided projection, with all the char- acteristics of "Potts' disease." This case was also, at the same time, examined by Dr. Andrews. An apparatus, to relieve pressure and separate the bodies of the diseased vertebrae, was applied and worn constantly, day and night. Great relief from suffering was immediately expe- rienced, and at present (May 9, '67) the deformity is scarcely perceptible, and the locality of the disease can be discovered only by a very careful examination. The back is perfectly strong, and no evidence of disease remains. The patient will be required to wear the apparatus a short time longer, when it will be discarded. The arrest of the deformity and cure, by anchylosis, of the vertebrae in their mal-position, is the general result of treat- ment in these cases. The disease being essentially one of in- flammation of the bone and soft structures of the spinal column, followed by absorption and, frequently, caries, it is greatly aggravated by pressure. The present case illustrates the fact, that when the weight of the body is effectually and for a sufficient length of time re- moved, the inflammation will subside and new bone frequently be deposited to take the place of that destroyed, and the nor- mal symmetry of the column be restored. This favorable result cannot be obtained in all cases. To insure such a recovery, there should be no anchylosis in any part of the diseased sur- faces, as this would prevent a sufficient separation of the bodies to restore the proper axis of the spine. The case should not be advanced to suppuration or formation of fistulae, for such a condition would render the application of a proper apparatus difficult. A satisfactory result is much more likely to follow when the inflammation is of a simple character and not com- plicated with, or dependent on, tubercle.

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PRIVATE RECEPTIONS. On Wednesday, May 8th, at 4 P.M., by Mr. and Mrs. George II. Pendleton, at their residence in Clifton. Carriages will leave Hopkins' Ilall at 2| P.M. On Thursday evening, May 9th, at 8 P.M., by Mr. and Mrs. Larz Anderson, north-east corner of Pike and Third Streets. On Thursday evening, May 9th, by Hon. C. F. Wilstach, at 8 P.M., No. 559 West Court street. On Thursday evening, May 9th, at 8 P.M. by Dr. and Mrs. George Mendenhall, No. 197 West Fourth street. On Thursday, at 12 M., May 9th, steamboat excursion in honor of the American Medical Association, by the City Coun- cil of Cincinnati. . The steamer America will leave the landing at Vine street, at 12 M. precisely. The Chief of the Fire Department, Enoch Megrue, Esq., will give an exhibition of the Steam Fire Engines, Thursday morning, at 9 A.M. Messrs. W. P. & F. P. Anderson, proprietors of Longworth's Wine House, will receive the delegates at 9 A.M., Friday, May 10th, at No 113 East Sixth street. Excursion to Longview Lunatic Asylum. Reception by the Superintendent, Dr. 0. M. Langdon, Friday, May 10th, at 4 P.M. A special train will leave the Cincinnati, Hamilton & Dayton depot at 3J P.M., for the Asylum.

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FURTHER NOMINATIONS. The Committee on Nominations made the following additional nominations:-- On Prize Essays--Drs. Charles Woodward, W. W. Dawson, S. B. Stevens, Robert Bartholow, P. S. Connor. Committee of Arrangements--Drs. Grafton Tyler, Wm. P. Johnson, F. Howard, Wm. Murburry, Lewis Mackall, T. F. Mowry, J. M. Toner, of Washington, D.C. Assistant-Secret ary--J. W. 11. Lovejoy, of Washington, D.C. Dr. Samuel Willey was added to the Committee on Necrol ogy, for Minnesota; also, Dr. S. M. Welch, of Texas.

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FEMALE PHYSICIANS. Dr. Atlee called from the table his preamble and resolutions, proposing to recognize female physicians by the same rules and limitations as other physicians. The vote on taking them from the table was 57 ayes to 52 nays. As there was no time for satisfactory discussion, Dr. Atlee moved the previous question, but it was not sustained. Dr. Fallen, of St. Louis, said:--"At home, I am considered a friend of the ladies, and nothing would give me greater pleas- ure than to advocate their claims, where it could be done legit- imately. But in Europe, Austria, France, and Prussia, the practice of medicine and obstetrics by females has proved a total failure. It is contrary to the spirit of our profession to have anybody connected with it except men, and men of reason. Nature has so ordained the female that, at certain periods, she is absolutely unfitted to do anything, consequently, could not attend to the legitimate duties of the physician. Another seri- ous objection--no person can practice medicine or surgery without a knowledge of pathological anatomy, and no woman having sufficient delicacy to enter the sick chamber, would enter the dissecting room to obtain such knowledge. Imagine a lady, with her style of dress, flitting around in the charnel house, or with microscopes diving into cancer cells. Pass such a resolution as this, and a thousand women about the country, practicing specialties connected with the female organization, will demand recognition at our hands, and claim authority for their business pretensions. I think the resolution should be voted down, because it is contrary to the laws of nature for women to practice medicine. Dr. Davis stated that at this late period of the session there was not time to enter upon any general discussion of the sub- ject before them, and, consequently, he moved to refer the preamble and resolution offered by Dr. Atlee to the Committee on Ethics. Dr. Bowditch advocated the adoption of the resolution. But the motion to refer to the Committee on Ethics was carried by a large majority.

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PROCEEDINGS OF MORGAN COUNTY MEDICAL SOCIETY. The Morgan County Medical Society held its regular month- ly meeting in Freman's Ilall, in Jacksonville, on Monday, May 9th. The meeting was called to order at 11 o'clock A.M., by the president, Dr. R. E. McVey, when the minutes of the last meeting, as printed in the Jacksonville Journal, were read and adopted. The Examining Committee recommended the names of Dr. 0. Long, of Jacksonville, Dr. G. A. Wilson, of Virginia, and Dr. J. II. Brown, of Waverly, for membership, when they were unanimously elected. Dr. J. Rhodes, of Jacksonville, was elected an honorary member of the Society. Dr. D. A. Logan, of Newmanville, Cass County, J. G. Cox, of Jacksonville, T. N. Stewart, of Exeter, and E. F. Baker, of Alexander, were nominated for membership. The following notice was passed: That the corporate members of the Society present be assessed the sum of one dollar and fifty cents for the expense incurred in the Society dinner--and if the amount raised by said assessment exceed the expense thus incurred, the balance shall remain in the hands of the Treasurer, subject to the order of the Finance Committee. The Society then proceeded by ballot to elect its officers for the ensuing year, with the following result: President--Dr. Henry Jones. Vice-President--Dr. S. Weagley. Secretary--Dr. C. T. Wilbur. Treasurer--Dr. John W. Craig. In electing the Examining Committee, it was moved by Dr. Prince that the five individuals who received the highest num- ber of votes upon the first ballot should be declared elected. Drs. Prince, W. S. Edgar, Long, Askew, and Fisher, were elected as the Examining Committee for the ensuing year. Drs. Prince, Edgar H. Jones, Wilbur, and Craig, were elected delegates to the State Medical Convention. The following report of the Secretary for the last year was then read: Gentlemen: Custom makes it incumbent upon me to pre- sent a report at the expiration of my term of office. By cus- tom I do not refer to the action of a long line of predecessors, but to what is done by all dignified bodies, like ours, which have Secretaries. I ought, but shall not be able, to give an exact statistical report of the attendance upon our meetings. Also a volume or two of praise to those who have been punctual and faithful to the Society, and who have labored from the first to make the exercises entertaining and instructive, and a sound lecture to those whose short-comings have been long suffered. Fourteen meetings have been held during the past year, with a very good average attendance. There are now connected with the Society, thirty-five corporate members, and thirteen honorary members. Four of the corporate and four of the honorary members reside out of the county. During the year we have had seven essays read upon the subjects, by the individuals and in the order hereinafter men- tioned : On Cholera, by Dr. II. Jones. Agency of mercury in cholera, diarrhoea, and similar diseases, Dr. D. Prince. On idiocy and its relation to the medical profession, Dr. C. T. Wilbur. On ergot of rye, Dr. W. S. Edgar. On phthisis and its relation with scrofula, Dr. R. E. McVey. On puerperal fever, Dr. D. Prince. On the Calabar bean, Dr. R. Malone. Our meetings have been enlivened by some very spirited and interesting conversations on the following topics : Ventillation, or the means of changing the viatated air of the sick-chamber. Osteo myelitis. Injections by hydrostatic pressure in acute dysentery. A case of malpractice, introduced by Dr. Prince. Tartar emetic in uterine inertia. Nomenclature and classifica- tion of febrile diseases, introduced by Dr. H. Jones. Ergot. Local anesthesia. Introduction of mecurials into the materia medica. Classification and treatment of cutaneous diseases, introduced by W. S. Edgar. Impurities of castor oil, intro- duced by Dr. Warrinner. Production of insensibility by cold ingeniously applied, introduced by Dr. G. V. Black, who ex- hibited apparatus. Cerebro spinal meningitis, introduced by Dr. J. P. Johnson. Some very remarkable and interesting cases occurring in the practice of the various members of the Society have been men- tioned and commented upon, of which we cannot in this report make further mention. A fee bill for the mutual benefit of the members of the So- ciety, to serve as a general guide, was framed and adopted at the meeting held in December, 1866. The reports of the Society, from month to month, have been published in the Jacksonville Journal, and several of these reports have been copied into the Chicago Medical Journal and Examiner--in fact, every report has been published that has been sent to these medical journals by the Secretary. We have in store for the coming year, essays on various topics, promised by Drs. Prince, Henry Jones, II. K. Jones, W. S. Edgar, J. W. Craig, and others, and our meetings, it is hoped, will be still better attend- ed than during the past year. It is also hoped that interesting and rare cases may be reported, and that there may be no lack of topics for conversation for each monthly meeting of the com- ing year. Our meetings have been characterized by uniform courtesy of demeanor, one to ' another, and there has been a complete absence of personalities in our discussions and of any disposi- tion to carry out the common opinion of the public that doctors never agree. On the contrary, the most perfect harmony of action and interchange of good nature have prevailed. In short, our meetings have been such as to cause feelings of pride that we are so generally amiable and fraternizing. There have been no symptoms of intolerance manifested toward the transi- tory Lighthills, O'Learys, and Finns, and even stationary charlatans have been permitted to bleed their dear public, ad libitum, "With no one nigh to hinder !" In conclusion, I would respectfully return my thanks for the honor conferred upon me, and the charitable manner in which the imperfect performance of the functions of my office have been received. The foregoing report is respectfully submitted. C. T. Wilber, M.D., Secretary. The Treasurer's report was next read, and both reports were accepted by the society. Dr. McVey then delivered a spirited and eloquent valedic- tory address, after which he vacated the Presidential chair, and the newly elected president, Dr. Henry Jones, was conducted to it. Dr. Jones briefly remarked that he was completely unprepared for any remarks, as the result of the election was entirely unexpected by him. A resolution of thanks for the able manner in which all the duties had been performed by the officers of the last year, was unanimously carried. The Society adjourned at half-past 1 o'clock to meet at the Dunlap House at 2 o'clock P.M. At 2 o'clock P.M., the members of the Society assembled at the Dunlap House--where an excellent dinner awaited them. After the invocation of the Divine blessing, by Dr. Johnson, all proceeded to discuss the viands so bountifully spread out before them, and there seemed to be no sign or symptom of impared digestive functions among the whole fraternity. The members were then called to order'by the President, when the Secretary announced the following toast: "The early practice of Jacksonville," and called upon Dr. Henry Jones to respond. The doctor then opened the "feast of reason" with the fol- lowing remarks: The early practice of medicine in Jacksonville was similar of course to medical life in other new settlements, characterized by hard work, low charges, long credits, and payment in the end, not always, or generally in legal tenders. Hard work--for in those early days practitioners were nearly all gathered in the larger villages, and the doctor's cir- cuit, if not as broad as the Methodist preacher's, was no narrow one, requiring long rides by night and day, and frequently, long, protracted absences from home; and this work must be performed on horseback, for the doctor's duty led him over routes impracticable to gig or buggy--and any attempt to em- ploy wheels would have ended in sad discomfiture. Just such a life as is now being led in other localities, whose conditions are at present, what ours were some forty years ago. Yet, in the retrospect of these early times and ways, there is something by no means unpleasant. If the country was young, so was the doctor, for nearly all the practitioners then were young men, and labor-was easily bourne, which, I suspect, some of us would shrink a little from encountering now. And to us from the older States there was something fresh and piquant, and far from unenjoyable in the rough life of the times of which I speak ; and I shall not easily forget the warm hospitality, the kindness, and attention to the doctor's com- fort and well-being, so continually manifested by my earlier employers in my country rounds. This was characteristic of the time. We had few classes of doctors then. No homoeopathy or hydropathy. No itinerant specialists. No wonderful vagrant curers of sore eyes, or ears, or throats, or other "ills that flesh is heir to." Besides regular practice, we had nothing but Thompsonian- ism, or steam practice, and this high pressure affair soon col- lapsed. If still in existence, it is only probably to be found in operation on some far away frontier. On the heels of the Thompsonians came the "root doctors," also now, I believe, obsolete. These gentlemen called them- selves eclectics, rather an attractive designation, as it seemed to present the idea that in them was to be found the collected wisdom of all systems carefully separated from what was worth- less or erroneous. But the eclecticism of the root doctors con- sisted in the employment of a few articles from the vegetable kingdom to the exclusion of all other remedial means. The community did not seem to think that they had the root of the matter in them, and they passed away. There is a wise eclectic- ism (not talked about, but employed) which leads the intelli- gent practitioner to avail himself of whatever of value may be found in any system, and something of value may be found in those most heterodox, and, in general, most absurd. There is another form of eclecticism developed in later days, in which the practitioner selects his metliodus medendi, at dif- ferent times, and in different instances from all systems, no matter how antagonistic to each other, to meet the fantasies or prejudices of the constituency to which he ministers. This, which in another profession, would be like discoursing, in order to meet the requisitions of different creeds, at one time from the Bible, at another from the Koran, and at another from the Ilindo Shasters, is confined, I trust, to a very select and limited few. I will not occupy your time in relating incidents illustrat- ing medical life in Morgan County in days long past, all of you probably, even at this day, have an occasional experience of what, in other days formed our daily life; and enough of hard work and rough work still survives the changes of the inter- vening years. I have a pleasant remembrance of my early associates in practice in this county. They were intelligent, educated men, and entered with good will and energy into the life-work which they had chosen. But one of that number remains in the field, and he is here on this occasion. Some are dead, others have removed to other scenes. I should be glad to say a word in regard to them, and others who, like them, have occupied the position of pioneer doctors in the new settlements of the country. I hesitate, lest I should be thought to include myself in the number of those to whom I wish to pay a tribute as sin- cere as well deserved. If you will exonorate me from the imputation of such inexcusable egotism and vanity, for I detach myself from the number of those of whom I wish to speak, I will go on. What I wish to say is this--that I cannot look on the lives of these early practitioners without feelings of em- phatic admiration, and with a strong conviction that their hum- ble, obscure, laborious, self-sacrificing, and useful lives deserve a higher appreciation than it will ever be their lot to receive. With great labor, with no prospect of fame, with little expecta- tion of more than a bare support; with much self-denial, and often with much difficulty from year to year " in making the two ends meet," their best services were cheerfully rendered; and to many a remote and lonely cabin, the homely-garbed doctor, plodding patiently on from dwelling to dwelling, was, if not in aspect, in reality, an angel of mercy and a ministering spirit. Whatever his reward, it certainly was not of this world, but his memory will be green in the hearts of some who were subjects of his care. All laud and honor, say I, to these hum- ble workers in this noble calling, and let them not be forgotten when they are seen no more. In response to the toast, "Be short," Dr. David Prince remarked: "The whys and wherefores of the above sentiment I am really at a loss to understand. Physically I am neither short nor long. I am not aware that I am even accused of being " short " in professional or pecuniary relations to society. I must, therefore, pause, as I can conceive of no adequate rea- son why I should be called upon to reply to this sentiment. [The effect of the doctor's sentiment was a very happy one, as no one dared to be very prosy.] Dr. R. E. McVey was called upon to narrate the "pleasures of a country practice," which he did in a very brief manner. In response to the toast "The Morgan County Medical So- ciety," Dr. W. S. Edgar made the following remarks: If nature holds no anniversaries, she marks time by the rev- olution of the seasons, and we are reminded by the recurrence of spring-time of the organization of our Society one year ago. In adopting a name, the friends were not unmindful of the fact that Morgan County had been one of the most prominent and highly favored counties in the State from its first settle- ment. Indeed, while yet the smoke curled gracefully over the wigwams of Keokuk, Wapello, and Blackhawk, the pioneers of education appeared with those of civilization to appropriate the choice lands and localities to that high interest; and to their efforts at that early day, are we chiefly indebted for the leading part her sons have ever bourne in the eventful history that has since transpired, as well as for the truly enviable reputation our county* and city has enjoyed for its appreciation of educa- tion and true progress. In agriculture she has boasted the chief of farmers, whose fame as such was world-wide, leaving an enduring monument of individual enterprise and achieve- ment. As there is much in a name, we presume the truly enviable history of the county might contribute somewhat to the success of our enterprise, which did not begin its existence without misgivings on the part of its friends, lest through the indiffer- ence of some and inconvenience of other members of the pro- fession, it might fall "still born," or, at least not survive its dentition. But, as more hopeful councils prevailed, we here to-day verify, not simply the practicability, but satisfactory success of the experiment. The rapid advancement in all departments of medical sciences the past half century, we have reason to believe is mainly due to the numerous organizations of this character in our country and the civilized world. While other medical schools initiate the novice into our pro- fession, the school for thesis and debate cultivates and qualifies him for its arduous duties. The observations and theories which find their way into Med- ical literature through this crucible, are generally worthy the attention of the student of his profession. We are aware that there are medical gentlemen, of pretention, too, who, by a habit of non-intercourse with their neighbors, in consultation or discussion, foster the somewhat popular idea, that to be born the seventh son, or "in the light of the moon,' is to have medr ical knowledge by intuition which is preferable to the teaching of books or societies. But as few of us can boast these great natural advantages, medical societies are needed to impart knowledge in the regular and legitimate way, to the uninspired at least, while the study and practice of the medical profession, affords the means of the highest culture and development, both of the moral and intellectual man, when pursued with that end. If pursued for selfish, mercenary ends, and popularity in the profession, with an extensive practice, is attained as the fruit of a system of general demagoging, good Lord, and good devil, good Christian, good infidel, good saint, good sinner, good homoeopath, good allopath, all things to all men to gain money, it oertainly furnishes the occasion for cultivating the most undesirable character we can conceive. On the contrary, if the extended acquaintance and practice comes as the fruits of the successful treatment of disease, from laborious study of the profession and valuable contributions to medical science, it is truly an honor and satisfaction to enjoy such public confidence. x As the practice of our profession necessarily leads to a com- petition of a peculiar and delicate character, it is desirable that our social and friendly relations be such that a generous hand may ever be ready to cast the mantle of charity over any seem- ing dishonor or error of a professional brother; and as a means to this end we unite around the social board on this anniversary occasion. In response to the toast, " Southern Practice," Dr. 0. M. Long remarked that he would postpone any extended remarks until some future occasion. Dr. Rhoades responded to the sentiment, "Vicarious Finger Sight," with a few brief remarks. Dr. Askew, in response to the sentiment, "The Profits of Practice," remarked that, "if any practitioner of medicine hoped to make a fortune in the legitimate practice of his pro- fession, he was afraid he would be doomed to disappointment." Dr. Fisher, in response to the sentiment, "Experience versus Theory," remarked that "He could not understand why, when there were those present who had been much longer in the field, that he should be called upon to talk of experience. Though he deemed theory very important, yet experience was quite as essential to a successful practice." Dr. M. M. L. Reed gave a very thrilling narrative of "the difficulties of medical practice in the early settlement of Illinois." Dr. Johnson, of Lynnville, in response to the sentiment, "The fyrm the fruit of a successful practice," remarked: "I have the farm, and I will tell you how I got it, and how you may do likewise. Forty years ago, I pledged myself to total abstinence from all intoxicating drinks. I also made it a rule never to be away from my office unless called away by profes- sional business. By strict adherence to these two rules he deemed that a farm, if desired, would follow as the fruit of a successful practice." Dr. J. T. Cassell, in response to the toast, "Early Practice in Kentucky," remarked that "he believed that in the legiti- mate practice of medicine a practitioner could acquire a for- tune. In a few years' practice in Kentucky, by diligence and hard service, he had secured enough to supply his wants for the balance of his days." Dr. J. W. Craig, of Arcadia, in response to a sentiment read a brief and very humorous poem, wrhich was received with great applause. Dr. Gr. R. Bibb made a few remarks upon " The Tribulations of a Young Practitioner." Dr. Lucus responded to the sentiment, "Medical Science at home and abroad," and called out Dr. Prince. Dr. Prince made a few remarks and proposed "The Records of the Morgan County Medical Society," calling Dr. Wilber to respond. Dr. Wilber remarked that having taken up so much time of the Society in his report at the morning session, he would simply in the name of the Society offer a conundrum : "Why are the frequent non-attending members of the Society like gophers?" Because they make their marks here and there in little mounds of fresh earth, but that is all the Society sees of them. Dr. DeLeuw gave in response to "Change of Location," the sentiment, "a 'Pereat!' to all who pretend to be physicians, but who are only pretenders." Dr. Knight spoke in response to the sentiment, "Practice in Town and Country," and Dr. Weagley in response to "Medi- cine and Agriculture." Dr. Buckner suggested the propriety of adopting more method in the appointment of individuals to take part in the regular meetings of the Society. His remarks resulted in the passage of a motion instructing the Secretary to call upon the members in alphabetical order to prepare essays for the regular meetings of the Society. Drs. Askew and Buckner were announced by the president as the essayists for the next regular meeting. At 5 o'clock P.M., the Society adjourned to meet on the second Thursday in June. C. T. WILBUR, M.D., Secretary

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FEMALE PHYSICIANS. Dr. Atlee, of Philadelphia, offered the following: Whereas, The subject of female medical education is excit- ing attention, and regularly educated female physicians have established themselves as practitioners of medicine; and Whereas, Female Medical Colleges, embracing all branches taught in other colleges, and all the conditions for graduation exist in the United States for the separate education of females; and Whereas, It is important that the standard of education, and the observance of the code of medical ethics should be fostered and maintained by this Association; therefore, Resolved, That the American Medical Association recognizes well educated female physicians by the same laws that govern its own members. Dr. Bowditch arose to a point of order, and reminded the President that the Association had postponed the order of the day for five minutes to Dr. Storer's question of privilege. He claimed that the five minutes had expired, and he moved to lay the resolutions on the table, which motion prevailed without a negative vote.

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THE PRESIDENT'S ADDRESS. Dr. Askew, the President, then delivered his inaugural address, an hour in length, but pertinent and important as it was comprehensive. He first referred to the origin of the Association, and sketched its usefulness in its history for the past eighteen years, showing how it had elevated and rendered more efficient the medical profession in the United States. The membership included about three thousand practitioners, scattered in every section of the country, through whose in- fluence the power of the Association was disseminated and exerted among the profession at large. The printing of the reports and papers submitted to the Association, in the volume of annual published proceedings, was instrumental in spreading a knowledge of the facts discovered and experimented upon by the more scientific. He called attention to the fact that never more than 1100 of these volumes had been distributed, and of late years only 500 volumes, whereas they should be in the hands of every intelli- gent and progressive physician. He treated briefly of specialties in medicine. He admitted that the science of medicine, in connection with the endlessly varied forms of disease, was too vast to be comprehended fully and practically by any one mind, and therefore devotion to any one or a few branches of the art of curing disease was not to be condemned; but he suggested that, inasmuch as the special practioner was likely to be unfamiliar with and unskilled in regard to the general symptoms or general causes of special diseases, consultations between the special and general prac- titioners would be conducive of good results. Neither should entirely ignore the other. In regard to empyricism, the President said the profession was in some degree responsible for its existence. It had for- merly frowned upon all dissemination of medical knowledge among the people, leaving them the prey to pretenders. The teaching of physiology,' botany, etc., in our schools, was a step in the right direction, which he hoped would be continued in other departments of medical knowledge. The subject of a better grading and more thorough instruc- tion in medical colleges was urged upon the consideration of the Association. The practice of using opium as a stimulant, by respectable people, who condemn the use of intoxicating drinks, was ad- verted to, and its destructiveness of health and life urged as considerations why physicians should exert their influence to check the evil; that influence might be brought to bear upon our Legislatures, to secure enactments against the sale of the drug, except on prescriptions. The list of Special Committees were called in order, and such reports as were ready were referred to the appropriate Sections for consideration.

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PRIZE ESSAYS. Dr. F. Donaldson, of Baltimore, from the Committee on Prize Essays, reported that they had received eight essays, all of which had been carefully examined, and after fully weighing the merits of each, two had been agreed upon as being the most meritorious, and they had awarded the prize of $100 each to the following: First--"An essay on the Causes of Intermittent and Remit- tent Fever," bearing the motto, "Fortes est veritas." Second--"On the Treatment of Certain Abnormities of the Uterus," Motto, "Empyricism in Medicine and Surgery is fast giving way to the Rationalism of true Diagnosis." The sealed envelopes containing the names of the authors were then opened, and the announcement made that the author of the first is Dr. J. D. Black, of Newark, Ohio; of the second, Dr. Montrose A. Pallen, of St. Louis, Mo.

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UNOFFICINAL MEDICINES. Dr. Hibbard called up his resolutions on unofficinal medi- cines, viz.:-- llesolved, That the habit of using unofficinal preparations of medicine by physicians, except where there is no officinal prep- aration that will answer the purpose as well, is unscientific and imprudent, tending to demoralize the therapeutist, and to en- courage irregular pharmaceutists and nostrum makers, and should be abandoned. Resolved, That the profession should not patronize druggists who are engaged in the manufacture of nostrums. Dr. Hibbard explained that the object of the resolution was to discourage the use of medicines prepared in peculiar and attractive forms, and insidiously introduced throughout the country, that might be genuine and might not, but which, at any rate, tended to confuse the practice. Dr. Post suggested that instead of the word "unofficinal," the word "secret" be used. Dr. Levick spoke of these prepared medicines as becoming a great evil. No prescription should be written which could not be put up by any apothecary. Dr. Cox expressed the opinion, that the profession should not patronize any druggist who manufactured, advertised, or sold quack medicines. Such druggists, while making enemies to the regular profession, taking their patients from them, had no right to approbation or support from those who confined themselves to regular and legitimate prescriptions. Dr. Howard remarked:--We have a right to regulate our own affairs, but we have no right to interfere with the business of the apothecary, or hinder him from selling what he pleases. Dr. II. A. Johnson, of Illinois, said:--The question seems to be whether it is or is not professional to use remedies not recog- nized in the standard pharmacopoeia of the profession. It does not become this profession to countenance quackery, but we should be free to use any of those remedies presented by the so-called Eclectics, or Hydropathics, or resort to the use of preparations first advanced by Ilomoeopathists, provided we find them useful in overcoming disease. We should stand on the broad platform of science; and no matter from what source remedies come, whether presented by a school of medicine called quackery, or through channels which we are accustomed to call legitimate, we should accept what proves to be useful. In the hands of scientific men they will become legitimate. And these preparations and elixirs that have been referred to, they are not secret remedies; we know what they are, and what their value, and I must feel at liberty to use them, get them where I can. After further discussion, the resolutions were referred to the Committee on By-Laws.

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ADDRESS OF GREETING. Mr. President and Gentlemen of the Association: It is my pleasant duty to greet you on this occasion, and to give you a cordial welcome to this city. I welcome you also on behalf of the profession, and of the citizens at large. Seventeen years ago this Association honored us with a meeting. Now, as then, we are happy in having the pleasure of greeting representatives from all parts of our beloved country. It is, then, sir, with feelings of no ordinary pleasure, that I welcome this Association--American by name, national and catholic in spirit--once more to the hospitalities of our city. Its history is bright with the names and labors of the great and good in all parts of our country. It has harmonized the profession, elevated its tone, stimu- lated a desire for a higher standard of medical education, and above all, has drawn a line as of fire between the scientific physician and the empyric, by adopting the Code of Ethics. Its power for good is hardly to be estimated. Its yearly transactions have received high commendation. No man in the profession can be indifferent to it. Much remains to be done to make its labors still more valuable. Without any power from the State or the National Govern- ment, to execute its mandates, it must for the future, as in the past, rely on the union, enthusiasm, and scientific labors of its members. Having the highest confidence in the capacity of the Asso- ciation for usefulness, and trusting that its labors may be still more conducive to the advancement of the science and improve- ment of the art, I bid you God speed in your efforts, and again most heartily welcome you to our city and our homes, as dis- tinguished and honored guests.

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COMPENSATION TO THE SECRETARY. On motion of Dr. Pullen, the Permanent Secretary was au- thorized to draw an order on the Treasurer, which the President shall sign, for such an amount of money as shall cover his annual expenses in attending the regular meetings of the Asso- ciation.

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THE CHRONIC INSANE. Dr. Lee, of New York, presented the following:-- Resolved, That providing for the poor chronic insane in the jails and almshouses of our country, as at present practiced in nearly all the States of the Union, is a gross violation of the laws of humanity, and contrary to the divine injunction of doing to others as we would be done by. Resolved, That when the regular hospitals for the insane of a State are insufficient to accommodate both acute and chronic cases that are sent to them, this Association would strongly recommend the procurement of a suitable amount of land in the vicinity, and the erection of convenient, well-planned, and well- ventilated, but comparatively inexpensive buildings, in connec- tion with and under the same general supervisor as the hospi- tals themselves, where those who are able to labor, and would be benefited by light, regulated employment, may be suitably accommodated and properly cared for. Resolved, That the example of Mass, in establishing asylums for the accommodation and humane treatment of the chronic insane, is worthy of all praise and imitation, and in the opinion of this Association, such institutions, if rightly inaugurated and judiciously carried on, will be a benefit to the State in an eco- nomical point of view, will raise the character of the State hos- pitals, and will greatly subserve the interests of the insane generally. Resolved, That as the present insane hospitals are capable of accommodating but a small proportion of the 40,000 of the in- sane of the United States, and as almshouse and jail provision is not adapted to their proper care and treatment, this Associa- tion would recommend to the proper State authorities to make such further provision in the direction above indicated, as may tend to the amelioration of their condition, if not the restora- tion of their rational and moral faculties. They were referred to the following committee, viz.:--Drs. C. A. Lee, New York; Gundry, of Ohio; John Fonerton Walker, of Massachusetts; and Chipley, of Kentucky. The Association then adjourned, sine die.

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NOMINATIONS AND PLACES OF MEETING. The Committee on nomination of officers, and place of meet- ing, reported as follows: Place of meeting, New Orleans. President--Samuel D. Gross, of Pennsylvania. Vice-Presidents--A. C. Post, of New York; Jno. II. Atlee, of Pennsylvania; D. W. Yandell, of Kentucky, and II. R. Storer, of Massachusetts. Permanent Secretary--William B. Atkinson, of Pennsylvania. Assistant Secretary--J. G. Richardson, of New Orleans. Treasurer--Casper Wistar, of Pennsylvania. On motion of Mr. Davis, of Illinois, that portion of the re- port, naming the place of meeting and officers resident there, was laid on the table. The rest of the report was then adopted. Dr. -Davis remarked that the crisis had arrived, which he had long anticipated, when the matter of eating and drinking, and entertaining the Association had come to involve such an ex- pense, that no invitation had been extended in advance, by resident members of the profession, for the Association to meet in any city, and the Committee had reported New Orleans, without an invitation from any one there. While there was no city in which he would like better to meet on personal accounts, and as a manifestation of reunion with the south, he felt that it would not be right to impose a meeting of the Association on that city. It was embarrassed in every relation of life, like all other places in that direction. It was impoverished, and though they would no doubt receive us with cordial and open hands, it would be wrong to tax them in that way. They could not vie with the liberality and extravagance of Cincinnati; or if they did it would be at a sacrifice we should not admit of. lie would give them another year to recover, and an opportunity to invite us. lie therefore offered the following: Resolved, That the next annual meeting of the American Medical Association shall be held in the City of Washington, on the first Tuesday in May, 1868, and every second year thereafter, until otherwise ordered by the Association. Resolved, That whenever the Association shall meet in the City of Washington, as directed in the above resolution, the Committee of Arrangements be strictly forbidden cither to pro- vide themselves, or except provision by others, of any enter- tainment or excursion whatever. Dr. Yandell, of Ky., arose, and was urged to take the stand, where he said: "I have listened with pleasure, and derived some new light from the remarks of the gentleman from Chicago. I arise to explain the motives of the Committee in naming New Orleans, and in doing which, I think I shall violate no con- fidence. When the place of meeting was called for, Dr. Hora- tio Storer of Mass., proposed New Orleans. The motion was seconded by Dr. Alonzo Palmer of Mich. As one of the few representatives from the South, I chanced to be in the Com- mittee, and was asked my opinion in reference to New Orleans. I confess to you, gentleman, that I never listened to a propo- sition in all my life which excited such emotions in my breast, as this motion coming from Massachusetts, and seconded by Michigan, to take this great body, of brethren across the crim- soned waste of war, and hold out the hand of fellowship to their brethren in the South. [Cheers.] I confess to you that when Dr. Storer, of New England, and Dr. Palmer, of the mighty west, moved that we thus extend the hand of brother- hood to the medical profession in the South, I could not restrain my emotions from bringing tears of joy to my eyes. The first question was whether it would be acceptable to New Orleans. I felt that I had some right to speak for the profess- ion in New Orleans. My excellent father and myself had taught many of them as students in medicine. I had served with them, and was personally acquainted with most of those who had been in the Southern army. I knew they felt as I feel, that when peace came in 1865, we had been united again; in fact, that we had never been divided; that though politicians had separated us by geographical lines, still the great republic of letters was one; that "No pent up Utica contracts our powers, But the whole boundless continent is ours!" In the great republic of science all geographical lines should be obliterated. We of the South, and you of the North, the East, and the west, have a common heritage. The ashes of the illustrious Drake lie in your beautiful cemetery here. Have we of the South no claim to, nor interest in his name and his fame? Ileve you of the North no interest in the long list of great and good men who adorn the profession in the South? No interest in those whose labors have added glory not only to medicine but to the nation? Hence I said I believed every man in the South, in that land of flowers, of the mocking bird, and of beautiful women, waited but to have your hands extended to them to give you a welcome. [Cheers.] I said to the Committee that New Orleans was poor, that the whole South was poor, but that you wTould not be less welcome to sit under our vines, and to take fruit from our fig trees; that we could not give you such splendid entertainments as Cincinnati has done; but we could do what was better than eating and better than drinking, we could give you the warm grasp of the hand that you would take with you in memory to your homes. In view of this the Committee honored itself and honored New Orleans by selecting that place for its next meet- ing- I see the objection of Dr. Davis, but if he proposes to do no eating and no drinking at the next meeting, New Orleans is a better place than Washington City. [Applause.] If you want to put the Medical Association on low diet, go down there. [Cheers.] But the very reason of all others which should take the Association South of Mason and Dixon's line--if such a line there be now--is that the Southern people are not able to come to you. They are not here to-day because they could not afford to come. But they would welcome you to their homes. If you do not go to New Orleans, then go to some place within their reach. I)r. Griswold, of Ohio, moved to substilute Knoxville, Tenn., instead of Washington City. Dr. Sayre moved to substitute New Orleans, as in the origi- nal report. He thought that with Dr. Davis' resolution of re- striction as to entertainments, there would be no objection to that place. Dr. Cox, of Md., indorsed all that had been said by his friend from Kentucky; was proud that one man from the South had expressed himself as standing on the platform of the union of the medical profession. He never supposed there would be any difficulty in reuniting the profession of medicine after the war was over. As to the entertainments of the Association, he was in favor of them, and thought if Dr. Davis' measure was adopted the usefulness and attendance of the Association would be impaired. In England they did far more eating and drinking than was done here, and yet they accomplished a large amount of work. Dr. Storer, of Boston, said the object of these meetings was to bring as many of the profession together as possible, and it should meet in such places as -would accomplish that object. We should not meet where we have not been invited by resi- dent members. That thing had been tried in Boston, and came near failing. The probability was we would be well received; but we ought to wait for a proper invitation. The hour having arrived for the steamboat excursion, the whole subject was laid upon the table.

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STEAMBOAT EXCURSION. At 12 o'clock the Louisville mail steamer America presented a lively appearance. It will be remembered that she is the magnificent two-storied steamboat, built expressly for the Louis- ville line, her equal is hardly to be found on any waters east or west. Tickets of invitation by the City Council had been dis- tributed liberally among official and prominent men in the city, who, with their ladies, to the number of six or eight hun- dred, stood on the decks and balconies to welcome the city's guests. The members of the Convention, with their ladies, arriving about half-past 12, and mingling with our people in the gay cabins, or in the genial sunshine on deck, presented the liveliest throng we have seen for many a day. A band of music entertained the company, if such a thing were needed in such a concourse of intelligent and socially disposed people. The guests cared more for taking a view of the city from the upper decks, as the noble vessel glided down its river shore, and further down to admire the hill-sides, covered with vine- yards, and the valleys filled with gardens. At 1 o'clock the band took position in the middle balcony of the cabin, and to a lively march the company assembled around the extensive tables of the steamer, and partook of a grateful lunch. Dr. G. H. Dougherty, Chairman of the Council Committee on Excursion, made a brief address of welcome to the visitors and assured them of the city's pleasure in having them among us. The trip was extended only to North Bend and return, with- out landing, as the vessel had to be back in time to receive her cargo and passengers for departure to Louisville at 5 o'clock. At 3 o'clock the company left the boat, greatly pleased with the brief season of recreation. FOURTH DAY'S PROCEEDINGS. The Association met this morning, the fourth day of its ses- sion, with about half the usual attendance, President Askew in the chair. The following named gentlemen were elected members by invitation:--Drs. John Dillard, of Lexington, Ky.; A. J. Larey, Mt. Pleasant, Kansas; S. S. Gray and A. S. Ashton, Piqua, 0.; John A. Warder and J. D. Stubbles, Cincinnati, 0.; Dr. Marsden, of Quebec, Canada; G. M. Kellogg, of Iowa; Dr. Maloy, of Cincinnati.

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PLACE OF NEXT MEETING. The subject of the next place of meeting was taken up, by Dr. Hammer moving that St. Louis be designated as the next place. The subject was finally disposed of, by choosing Washington City as the place of meeting, and requiring the Committee of Arrangements to avoid any entertainments that will interfere with the business of the Association or of the Sections.

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REPORT ON RANK OF MEDICAL MEN IN TIIE NAVY. This paper, by Dr. Pinckney, a surgeon in the United States Navy, excited a great deal of interest and approbation. It was a most bitter but dignified protest against the discrimination made between officers of the line (military men purely) and the surgeons in the naval service in regard to title, pay, and official and social privileges. He contended that while men of the medical profession were everywhere recognized as the equals of those in other professions, in the navy they were degraded below the military, inferior in age, in experience, and rank. He said: Our service is overgrown with usages which sprung up in the earlier and ruder ages of naval life, and still cling to it with a power and tenacity which almost defy modern enlightenment, progress, and even law. It is probable that the national author- ities which organized the existing rank of medical officers intended to confer a more substantial fact than the usages of shipboard life have permitted. Among the usages of the ser- vice is that which limits an officer's rights and comforts to the apartment in which he messes, even though his rank actually entitles him to higher privileges and greater comforts than belong to those of an inferior rank who make up the majority of the inmates of that apartment. The steerage is the most humble of those apartments, and is the dwelling-place of the very young, or those of no responsibility. The ward room gathers in it most of the commissioned and some warrant offi- cers, and was originally occupied by none of higher rank than Lieutenant. All its usages and government are still conformed to the scale of that grade. Now, make a medical officer in name an Admiral, and leave him to be ward room officer, and the title becomes ridiculous. It is sunk below the usages and restrictions originally designed for those of junior years and inferior rank. There is only one mess which is superior to these restrictions, and that is the mess or messes of the commanding officers, and their associates, who may range in rank from a Lieutenant Commander to an Admiral. Sometimes there are one, some- times two of those messes. This is very properly left to the will of the Commander-in-Chief, who may choose that he and his Captains may have one or separate establishments. The Assistant Surgeon enters the service with the rank of "Mas- ter." That this title may not be misunderstood, it may be necessary to explain that it is the lowest rank in the wardroom. For the incumbent is in modern times generally a graduate of the Naval Academy, awaiting his promotion to lieutenancy. Like the "Master," the Assistant Surgeon, at once becomes a member of the ward room mess, and unless the number of par- titioned off sleeping berths contained in the ward room are occupied by his seniors, he may have the good fortune to occupy one of those that are dimly lighted by an air port, six inches in diameter. This space is so restricted, and the separation from the common apartments is so slight, that words in an ordinary voice in another become common property. After further pre- senting the discriminations against medical men in regard to shipboard accommodations, the Doctor said: "The general law is that no officer shares in prize money unless his name be bourne upon the books of the vessel making the captures; but the Admiral or Commander-in-Chief has a per centage on all prizes made. The fleet Surgeon as a mem- ber of the Commander-in-Chief's staff must be with him in the flag-ship, and as a rule at the post of greatest risk, responsibility, and hazard, consequently he is not likely to have his name borne upon the books of the subordinate vessels making cap- tures, and yet no share of prize money is allowed him." The report suggests the following as the remedy for these evils: 1. After they have reached the rank of Commander, or are filling the position of Fleet Surgeon, let them be by right, as they often have been by courtesy, members of the cabin mess. If the mess of- the Commander-in-Chief be too exalted a social position for the members of your profession who are filling the important position of Fleet Surgeon, then let them be members by right of the mess of the Commander of the ship and the Fleet Captain. 2. An equitable arrangement of prize money, most impor- tant in principle, your Committee hope to see effected. It will, however, require future legislation. In European countries, the doctor said more liberal regula- tions prevail in regard to naval Surgeons than in democratic America. The late Admiral Foote, so justly distinguished for his large medical liberality, advocated the highest rank for naval medical officers. An Admiral among the most distinguished in the service, has authorized it to be officially said that he thought the Fleet Surgeon should in our service, as in the French, be a member of the Commander-in-Chief's staff and family. We regard it as opposed to the public interests of the service, I which can never be sacrificed to gross indignity without detri- ment. The Committee offered the following resolution: Resolved, That a Special Committee of five be appointed by the President of the Association, to present this subject before the President of the United States and the Secretary of the Navy, and urge the adoption of the changes proposed. The resolution was adopted with a universal aye, the report having been received with prolonged applause. When the list of Special Committees was finished, several volunteer papers were received and referred to the appropriate Sections. The Treasurer's annual report was read, accepted, and re- ferred. The delegates from the several States were requested to select one of their number to sit on the Committee on Nomina- tions. The Association then adjourned to 9 o'clock next morning. SECOND day's PROCEEDINGS. The Association met this morning with an increased attend- ance, the hall being completely filled. President Askew was in the chair. The following named persons were proposed and voted mem- bers of the Association by invitation: Dr. J. Taylor Bradford, Augusta, Ky. John P. Phister, Maysville, Ky. Wm. L. Atkins, Geo. H. Whiting, A. B. Duke, M. L. For- sythe, Paul Rankin, of Kentucky. M. W. Junkins, Galen Hart, E. P. Harrison, of Ohio. D. R. Greenly, Meadville, Pa. Fred. Wolf, Concord, Md. Eugene B. Harrison, Napoleon, Ohio. B. F. Ilart, Marietta, Ohio. Delegates from the several States presented the following named as Committeemen on nomination of officers: Vermont--J. N. Stiles. Massachusetts--H. R. Storer. Rhode Island--0. Bullock. Connecticut--B. II. Catlin. New York--E. Elliott. New Jersey--Samuel S. Clark. Pennsylvania--John L. Atlee. Delaware--II. F. Askew. Maryland--J. J. Cockrill. West Virginia--J. C. Hupp. Ohio--MTlwaine. Kentucky--D. W. Yandell. Indiana--J. S. Bright. Ill inois--H. A. Johnson. Michigan--A. B. Palmer. Iowa--J. C. Blackburn. Missouri--B. F. Shumard. Texas-- Hurd. District of Columbia--Johnson Elliott. United States Navy--N. Pinckney. United States Army--J. J. Woodward. Wisconsin--N. Dalton. Kansas--John Parsons. California--T. M. Logan. Tennessee--W. A. Atchison. The Secretary read a communication from Prof. Alden March, donating to the Association photographs of all the Pres- idents of the Association, a copy of which he transmitted to the custody of its proper officer for deposit in the archives. He also announced his pleasure to add to the collection in future. The donation was accepted with thanks. Dr. C. C. Cox read the report of the delegation to the Foreign Medical Societies, in which he gave an interesting resume of the proceedings of the British Medical Association, which met in Chester, England, in August, 1866. Referred to the Committee on Publication. The President of the Association appointed the following named gentlemen delegates to Foreign Medical Associations for the present year: Dr. B. Fodyce Barker, of New York; Dr. John E. Tyler, Massachusetts; Dr. Thomas C. Brinsmade, Troy, New York. Dr. II. R. Storer arose to make an explanation. On yester- terday he had made some remarks, when the report of Dr. Ray on insanity was called for and no response was made, deprecat- ing the fact that the Superintendents of Insane Asylums held themselves aloof from this Association. His remarks, he thought, had been misunderstood, and taken in a too serious and personal light. He was happy to say that while he was then speaking, Dr. Walker, one of those Superintendents, was on his way to this meeting, with Dr. Ray's report in his pocket. He proposed that Dr. Ray be made a member of the Associa- tion by invitation, and that his report be made the special order for to-morrow morning. Dr. Hibberd objected to departing from the rule of referring such papers to appropriate sections, as it would establish a pre- cedent that might consume valuable time of the Association hereafter. Dr. Walker explained that he had been delayed on his way by a railroad accident. He was surprised and grieved to learn, on arriving here, that an uncalled for assault had been made on this floor, on members of the Association of Superintendents of Insane Asylums. Every member of that Association would take it to himself, and the feeling could not be changed. He repeated the word assault, because the thing had been repeated now for the third time, and he repelled it. No member of that Association would ever again be drawn into this Association to make a personal reply. They had not thought it their duty to connect themselves with this Association, although efforts had been made to get members to come here and join the section on psychology; but if, when they came here, they were to be met with personal attack, this meeting would see the last superinten- dent of a Hospital for the Insane. He explained that the reason why they did not unite with this organization was, that their duties and interests as hospital superintendents were dif- ferent from those of ordinary physicians. It was from no want of respect for this Association. They were, however, ready to come in as individuals, and contribute their part in the work of this Association, provided they could be received courteously. Dr. Gross hoped the report of Dr. Ray would not be referred, but be treated with the courtesy of a hearing in open session. Dr. Storer again disclaimed any intention to give offense. He had endeavored to satisfy Dr. Walker of this, but he did not succeed. The report of Dr. Ray was then made the special order for this morning. The President announced the following Committee, to lay the matter of rank and privileges of Surgeons in the U. S. Navy before the President and Secretary of the Navy. Drs. N. S. Davis, of Illinois; J. M. Toner, District 'Colum- bia; S. I). Gross, Pennsylvania; J. J. Cockrill, Maryland; II. F. Askew, Delaware. Dr. S. D. Gross read a report on Medical Education, which presented very much the same views as were advanced and inaugurated for practice by the convention of medical professors in session here last week. He had for twenty years been an advocate for progress in the direction of more thorough attain- ments, and a more rational mode of imparting instruction, be- ginning with the elementary and advancing to the more difficult. He condemned entirely the custom of private medical pupilage as worse than useless. The report was ordered to be printed. Dr. Stille, President of the Medical Teachers' Convention above referred to, presented the action of that body, and asked the co-operation of the Association in carrying out the measures recommended. Dr. Davis, Chairman of the Committee that had been ap- pointed by this Association to call said convention, made a report, detailing the steps by which the work had been accom-

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THE CHICAGO MEDICAL EXAMINER. N. S. DAVIS, M.D., Editor. VOL. VIII. JUNE, 1867. NO. 6. (0 r i n i a a I o u t r t b it 11 a ir PS. ARTICLE XXIII. CASE OF HYDROPHOBIA. By DANIEL T. NELSON, Prof, of Physiology and Histology. T. P. A., a bright, intelligent boy of 15 years, was bitten by the pet family dog on the morning of Nov. 27th, 1866. The dog had shown signs of illness for several days, was irritable, was frequently biting his tail, which seemed covered with some kind of an eruption at its extremity, whether the cause or re- sult of the biting, not known. Character of the eruption, whether vesicular or pustular, not known. Did not eat well, but took some food and drinks. Drank water the day he bit patient. Did not froth at mouth, or show any unusual symp- toms except those mentioned, and these were not considered by the family of any consequence, as the dog had had three sdch attacks before--one during each of the three previous winters. The only noticeable feature of this attack was the time of its occurrence, earlier than usual in the season. The morning on which he bit the patient, he seemed better, and ate a cracker which he gave him. It was while feeding him with this that he snapped at him, apparently without provocation, inflicted a crescent shaped wound an inch and a half long in the left cheek, extending from the angle of the mouth, upwards and outwards, passing through the whole substance of the cheek. From the previous history of the dog, having had three attacks apparently in all respects similar, nothing was thought of the wound at the time. It was simply washed and drawn together with adhesive straps, when it healed kindly. During the day, after biting the patient, the dog presented no different symptoms, though he was not allowed to enter the house on account of his conduct in the morning. A few days after he was found dead, whether killed or not, not known. No further trouble of any kind was experienced by the pa- tient from the wound until Tuesday, Feb. 26, 1867, when, on coming in from play, snow balling, etc., he complained of "not feeling well;" throat a little sore; "that he had taken cold;" headache. Slept pretty well; sleep disturbed by dreams of fighting, etc. Wednesday, Feb. 27th.--Did not get up in the morning; sleepy; no appetite; thirsty; drank lemonade freely; throat no better. A homoeopathic physician was called, who is said to have treated him for diphtheria. About 12, midnight, began to complain of an uneasy feeling--a pricking sensation--about the cicatrix on the cheek. About the same time, also, slight con- vulsive movements were noticed in the voluntary muscles. Did not sleep. Thursday morning, Feb. 28th.--Convulsive movements more decided, and easily excited; occur spontaneously every half hour, increasing in severity and frequency during the morning. Some difficulty in swallowing; speaks rapidly and loud, (latter, perhaps, on account of slight deafness of mother.) February 28, 3 P.M.--I first saw the patient; found him sane, but restless; eyes rather wild and staring; pupil some- what dilated; tongue slightly furred; protruded spasmodically, and with difficulty; respiration labored; pulse quick; sufficient strength; heart's action accelerated; fluttering; face flushed; countenance excited; skin moist, natural; extremities extended, or moving spasmodically; cannot speak on account of spasmodic action of laryngeal muscles ; complains of sense of suffocation in throat and chest; want of sleep and thirst; water and all fluids immediately rejected by sudden and powerful contraction of muscles of throat and chest; ice and all solids spasmodically seized by the mouth, and at length swallowed, but with difficulty. Any attempts at moving the body, swallowing fluids, or speak- ing, produce tetanic spasms of most of the voluntary muscles; opisthotonos, with strongest convulsions; bowels moved Tuesday; urine passed. Thursday, P. M., 3 o'clock. Treatment, 3.15 P.M.--Atropine, gr. 3.30 P.M.--Ap- plied ice bag to whole length of spine. 3.1fT> P.M.--Feels better; swallows solids, and breathes with less difficulty; had infus. tobacco made, 5iij- to Oj., and boiled to 5viij. If. P.M.-- Atropine, gr. infus. tobacco, 5'j-, made into bolus, with common flour; swallowed without much difficulty; ice as de- sired. lf.,30 P.M.--Convulsive movements again on the slightest exertion, but not so strong. Atropine, gr. *0; too restless to keep ice bag to spine; pupils dilating well from atropine; delirium; face more flushed and eyes injected; breathes easy, and talks freely; desires to leave the room. 5 P.M.--Infus. tobacco 5ss., in bolus; vomited; ordered to be kept quiet. 5.30 P.M.--Henry M. Lyman, M.D., called in counsel; delirium; more quiet; pupils well dilated; pulse 130, and losing strength; patient seems exhausted; lies upon back, head thrown back (ophisthotonos). No change in plan of treatment deemed advisable; no light or attendant allowed in the room; perfect quiet enjoined. 7.30 P.M.--Atropine, gr. A- 8.30 P.M.--Atropine, gr. 9.30 P.M.--01. tobaci gtt. j., instead of infus. on bread pill. 10 P.M.-- Failing rapidly; respiration labored; not conscious. 10.30 P.M.--Opisthotonos increasing, as also general convulsions; respiration more labored; white, frothy mucus fills the mouth for the first time; saliva not noticeably increased or changed in character before; chloroform given by inhalation; muscles of chest relax, and respiration more easy; general convulsions also less marked. Kept sufficiently under its influence to quiet the tetanic spasms until death, 11.30 P.M.; died very quietly. At 11 P.M. the white mucus in mouth became of a rusty hue. Remarks.--The history of this dog has suggested to my mind the following queries:--(1.) Had this dog had hydrophobia three times before, and recovered, not extending the disease by happening not to bite any one? Or (2) was this a severe attack, proving fatal at last, (as it is not known but the dog died of the disease.) But he did not present many of the sup- posed symptoms of the disease? Or (3) are there other diseases to which the canine race is liable, during the presence of which the bite of the animal will produce rabies in the human subject? Indications for Treatment.--Without theorizing about the materia morbi, several indications for treatment are plainly presented. 1. To quiet the irritability of the nervous system, particularly of the cord. 2. To prevent reflex action. 3. Support the strength. To meet the 1st, the infus. tobacco was given till the ol. tobaci could be procured, nicotina not being in this market. Tobacco in some form was suggested, from its seeming efficacy in tetanus, which also affects the cord. But how shall we say it acts? Does it act directly upon the nervous tissue, paralyz- ing it, without particularly affecting others. The ice bag was applied to the spine on the supposition that the cord was hype- rsemic, from its excessive irritability, and in this way it was hoped the engorged vessels could be made to contract, and thus the irritability reduced. If this be true, that the cord is in a hypersemic state, might not several other remedies be used with success--drugs which are said to act upon the muscular coat of the arteries--such as aconite, ergot, turpentine, and perhaps tr. chid, iron and electricity--a strong current--and the bromide of potassium, recently recommended? Does this act in the same way? Will some or any of these drugs act upon vessels in the cord, and not upon vessels elsewhere? But the second indication suggested was to prevent reflex ' action. On the authority of Dr. Brown-Sequard, belladona in the form of its active principle, atropine, was used. And is its action really like tobacco, to produce paresis of nervous tissue, acting upon both elements of that tissue, or does it act only upon the fibrous motion, and thus prevent the conveyance of impressions ? With this in view, Dr. Brown-Sequard advises the removal of an inch or two of the nerve connecting the wound with the cord. The 3d indication was in this case toward its close, difficult to meet, all fluids being rejected by the mouth, and even enemas were not tolerated till late, per- haps too late to be of service. Animal broths, and all nutri- tious and easily digested articles of food, would seem to be indicated, given by the mouth if w'e can, by the rectum if we must.

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z i o r v jc u i u o vi << n n i n AMERICAN MEDICAL ASSOCIATION--EIGHTEENTH ANNUAL SESSION. This Association met Tuesday, May 7th, at 11 o'clock, A.M., in Hopkin's Hall. For an hour previous the reception room adjoining had been crowded with delegates, presenting their credentials to the Secretary, Dr. Wm. B. Atkinson, of Phila- delphia, enrolling their names, and receiving from the Cincin- nati Committees such attentions as the occasion has called forth. The Committee of Arrangements, Dr. John A. Murphy, Chairman, Drs. W. W. Dawson, J. P. Walker, R. R. Mcllvaine, W. T. Brown, J. S. Unzicker, and James Graham, presented each delegate or visitor, with a neatly-printed pocket pamphlet with a card-board cover, on the front page of which is printed "American Medical Association, Annual Meeting, Cincinnati, May 7th, 1867. This card will admit Dr.---------------- to the within named places." On the second page the following: " Places of Public Interest--Court House, City Jail, Young Men's Mercantile Library, Chamber of Commerce, Theological Library, School Library, Mechanics' Institute, Longworth's Wine Cellar, House of Refuge, Protestant Orphan Asylum, Catholic Orphan Asylum, Spring Grove Cemetery, Longview Lunatic Asylum, City Buildings, Greenwood's Foundry, Water Works, Medical College of Ohio, Miami Medical College, Good Samaritan Hospital, Commercial Hospital, Steam Fire En- gines." Next is a copy of Mr. E. Mendenhall's map of the city, stitched in and folded up in good style. Then follow sixteen pages of matter descriptive of the "Places of Public Interest" before mentioned, and numerous others, making a very credit- able City Guide, for the use of strangers visiting our town. The Committee on Entertainment, Dr. David Judkins, Chair- man, Drs. C. G. Comegys, W. H. Taylor, C. P. Wilson, T. Carroll, J. S. Dodge, and W. E. Foote, presented each dele- gate with a ticket to the entertainment, or banquet, at Melodeon Hall, last night, and another to the excursion on the magnifi- cent Louisville mail steamer America on Thursday. PROCEEDINGS OF THE ASSOCIATION. At eleven o'clock the President of the Association, Dr. Henry F. Askew, of Delaware, called the meeting to order. Rev. Dr. Storrs, of this city, offered a prayer. Dr. John A. Murphy, as Chairman of the Committee of Ar- rangements, then made the following

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MEETINGS OF THE SECTIONS. Dr. Murphy announced the places of meeting of the different sections of the Association, viz. : Chemistry and Materia Mediea--Medical College of Ohio. Medical Jurisprudence and Hygiene--Medical College of Ohio. Psychology--Dental College, College street, between Sixth and Seventh. Practical Medicine and Obstetrics--Dental College. Surgery--Medical College of Ohio. Meteoroloqy, Medical Tupoqraphy, and Epidemic Diseases-- Medical College of Ohio.

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We give so much of our space in the present number to the Proceedings of the American Medical Association, and the Convention of Delegates from Medical Colleges, that we have none left for book notices and editorial comments. Personal.--Our colleague, Edmund Andrews, M.D., Pro- fessor of Surgery in Chicago Medical College, and of Clinical Surgery in Mercy Hospital, will leave for Europe between the 5th and 10th of June. Prof. Andrews goes abroad neither for health or recreation, but for the purpose of profiting by a tour of observation in the hospitals and medical institutions of Eu- rope. He is also a delegate from the American Medical Asso- ciation to the International Medical Congress, to be held in Paris next. He expects to arrive home again before the 1st of October. We wish him a pleasant and profitable journey and a safe return. Bellevue Place.--This is the name of a private asylum for the treatment of the insane. An advertisement of it will be found in the proper plac#, in this number of the Examiner. We take special pleasure in calling the attention of our readers to the institution, because we are personally acquainted with Dr. R. J. Patterson, the Superintendent, and regard him as one of the most experienced and skilful managers of the insane in our country, and a man of perfect integrity. Money Receipts from April 22d to May 27tii.--Drs. H. H. Guthrie, St. Charles, Minn., $3; M. A. Fox, Shulsburgh, Wis., 3; J. B. LeBland, Brownsville, Minn., 3; A. Graetinger, Milwaukee, Wis., 3; Darius Mason, Prairie du Chien, Wis., 3; Harrison Rodebough, Greenup, Ill., 3; E. L. Holmes, Chicago, Ill., 3; D. B. Bobb, Dakota, Ill., 3; G. W. Rohr, Rockford, Ill, 3; R. L. Walston, Paris, Ill., 3; D. S. Jenks, Plano, Ill., 3; G. M. Fox, Lyons, Ill., 9; D. B. Wren, Fair Haven, Minn., 3; F. F. Stair, Paoli, Wis., 2.50; W. H. Cook, Hillsboro, Ill., 3; E. Dyson, Chicago, Ill., 3; Wm. J. Wheeler, Youngstown, Ohio, 3; E. Winchester, Elgin, Ill., 3. Fever, Scarlet,_________________ 7 Fever, Typhoid,---------------- 12 Fever, not stated,-------------- 3 Gravel,------------------------- 1 Hydrocephalus,------------------ 6 Haemorrhage,____________________ 1 Inflammation of Bowels,_________ 3 Inflammation of Brain,__________ 8 Inflammation of Lungs,__________ 6 Jaundice,----------------------- 1 Killed,_________________________ 4 Measles,------------------------ 1 Old Age,------------------------ 8 Poisoning,______________________ 2 Paralysis,---------------------- 1 Pneumonia,______________________ 6 Phthisis Pulmonalis,____________ 3 Rheumatism,_____________________ 1 Suffocation,-------------------- 1 Suicide,________________________ 2 Spinal,_________________________ 3 Stillborn,_____________________ 16 Small-Pox,______________________ 8 Chicken-Pox,____________________ 1 Spasms,_________________________ 1 Teething,_______________________ 6 Whooping-Cough.________________ 4 Unknown,______________________ 18 Mortality Report for the Month of April:-- CAUSES OF DEATH. Accidents,______________________ 3 Apoplexy,----------------------- 2 Bronchitis,_____________________ 1 Burned,_________________________ 1 Cancer,_________________________ 2 Cold,___________________________ 2 Croup,------------------------- 10 Cholera Infantum,--------------- 5 Consumption,------------------- 28 Convulsions,--------------------20 Childbirth,_____________________ 4 Congestion of Brain,------------ 4 Congestion of Lungs,------------ 1 Congestion,--------------------- 1 Delirium Tremens,--------------- 2 Decline,________________________ 2 Diarrhoea,---------------------- 2 Diphtheria,_____________________ 8 Dropsy,________________________ 11 Drowned,------------------------ 8 Disease of Heart,--------------- 5 Disease of Liver,--------------- 1 Disease of Throat,-------------- 1 Epilepsy,------------------1____ 1 Fever, Brain,------------------- 5 Fever, Spotted,----------------- 1 Fever, Puerperal,--------------- 1 Fever, Lungs,------------------ 10 Fever, Nervous,----------------- 2 Total,---------------------------------------------- z/o Total number last year for the month of April,------ 278 Total number during the month of March,__________________280 Total number during the month of April,__________________278 Decrease,------------------------------------------------ 2 DIVISIONS OF THE CITY. North______76 | South,____87 | West,_____113 | Total,___278 Unknown,------------------------------------------------- 2 Ages of the Deceased.--Under 5 years, 133; over 5 and under 10 years, over 10 and under 20, 13; over 20 and under 30, 26; over 30 and under ), 30; over 40 and under 50, 23; over 50 and under 60, 13; over 60 and under ), 11; over 70 and under 80, 7; over 80 and under 90, 1; unknown, 2. Total, r8. NATTVTTTF.S Chicago,------------143 Other States,________40 Bohemian,------------ 2 Canada,______________ 3 England,------------ 10 France,______________ 2 Germany,____________27 Ireland,___________ 38 Norway,_____________ 1 Sweden,_____________ 2 Scotland,___________ 2 Switzerland,________ 2 Vales,______________ 1 Tnknown,____________ 5 Total,_____________278

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ENTERTAINMENT AT IION. GEO. II. PENDLETON'S. At three o'clock this afternoon the members of the Associa- tion, accompanied by their ladies, such as were here, took a ride to the suburban residence of Hon. Geo. H. Pendleton, by invitation of the Committee, who furnished carriages for the purpose. The party numbered about three hundred, and were agreeably entertained. THIRD day's PROCEEDINGS. The American Medical Association met again Thursday morning, the hall being full, though not crowded as it was on Wednesday. President Askew called the meeting to order. Dr. D. H. Storer arose to a question of privilege, namely the honor of the Association. It was in debt, and its first duty was to take measures to relieve its executive officers from their embarrassments. He moved that every member be assessed a tax of $2, to raise the necessary funds. On motion, he was requested to prepare a subscription paper, and lay upon the table for voluntary subscriptions.

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PAPERS ON CHOLERA. The Secretary presented a paper upon the Cause and Man- agement of Cholera, by Dr. E. Harris, which was referred to a committee to examine papers designed for publication. Dr. Wm. Marsden, of Canada, presented a synopsis of an essay on the contagion, infection, and portability of Asiatic cholera, in its relations to quarantine, with a brief history of its origin and cause in Canada, from 1832. A motion to refer to the Committee on Publication was adopted, but afterward reconsidered, and the paper referred to the Committee on Revision, above authorized.

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PRIZE ESSAY MATTERS. The following resolution, offered yesterday, was taken up: Resolved, That hereafter the Committee on Prize Essays be requested to withhold the offer of a prize of $100 each, and that the successful essayists receive in lieu thereof a certificate signed by the President and Secretary, and one hundred copies of the essay, at the expense of the Association. This resolution was suggested by the failure of the receipts of the Association to pay printing expenses. I)r. Davis made a statement to the effect that if the different sections would conform to the ordinances of the Association, as to proper matter to be referred for publication, the expenses of printing would be greatly reduced, and the prizes could be paid. Dr. Robbins called attention to an amendment that had been proposed two years ago, requiring all members, whether present or absent, to pay an annual fee of $5. By the adoption of this amendment the Association would have ample funds. The subject was laid on the table until the amendment could be laid before the Association in proper shape.

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The new Treatment of Rheumatism. Messrs. Editors.-- I am glad you published Trousseau's formula from Parrish, as it enables me to correct an error. I had. not read it before, but simply saw it was announced as in Parrish's book. Trous- seau's own statement is of a syrup saturated with lime. " Il se prepare en saturant le sirop de sucre par le chaux et en filtrant." On looking at Parrish, I find it is to be made of slaked lime. This is entirely wrong. It should be made of caustic lime. The best formula would be to mix two (2) ounces of lime un- slaked and eight (8) ounces of sugar together in the mortar, and pour over the mixture a wine pint of boiling water. Add boiling water enough to mske up the pint, and filter. By the use of boiling water, the operation is more rapid and the for- mation of lumps is avoided. Of this I have given as as much forty-five drops every two (2) hours in one case of acute rheu- matism. Generally, thirty-five (35) drops in half (J) a tum- blerful of milk every three (3) has been enough. The diet in my cases has been left to the patient's choice. Boston, March I, 1867. Very truly yours, Chas. E. Buckingham.

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anntim. II.--ON THE INFLUENCE OF HYPODERMIC INJEC- TION UPON THE SCIENCE OF TOXICOLOGY. By S. P. DUFFIELD, Ph. D. So wide has been the beneficial influence of improvements in chemical analysis, that it would be superfluous to attempt to make any further observations on the important part per- formed by this branch of the science. When medicine, in the earlier times, stepped forth and claimed preeminence and respect, while the untiring alchemest, with his furore, furnaces and fumes, sought for that elixir which should place eternity within his control, she was then encircled by the fancies of her speculative philosophy, encumbering the studies of all her collateral branches. But in the present age, the exact methods of investigation have plunged her again into a new labyrinth of untenable theories. The famous trial of Palmer, in England, for poison- ing his victim with strychnia, drew all chemists to investigate most thoroughly the behaviour of this alkaloid to chemical reagents, and we now have full data and methods which render its detection and recognition quite easy and simple. The beautiful system of dialysis by Graham has been another step in advance, and can truly be called one of the aesthetics of toxicology, divesting it, as it does, of the curcuitous and very unpleasant course heretofore pursued in examining the viscera of a poisoned subject. But brilliant and rapid as have been the advances in this department of Chemistry, those very dis- coveries have turned up new obstacles to be overcome. Of late years, a system of introducing remedial agents into the circulation, more rapidly than can be done through the agency of the stomach, bids fair to place in the hands of design- ing persons a power which has never before been posessed by any within or -without the profession of medicine. I refer to the system of hypodermic injection, becoming now so deserv- edly popular with the "regular medical profession." This system owes its success to the facility with which poisons are introduced into the blood. From the earliest times, blood has been a favorite topic. Moses, in accordance with the views of the ancient Egyp- tians, placed the seat of life in the blood. One might, therefore, reasonably have expected that subject which had played such an important part in medicine would have had more than empirical support, on which to base some degree of accurate knowledge. When wre remember that only three-fourths of a century ago oxygen was unknown to the chemist, we can readily perceive wdiy former investigators were powerless. Even to physics, which had solved some of the great astronomical problems, the phenomena of the animal organism were a sealed book. Albinus took no meagre view of organic activity in nature when he established the axiom, that the essence of life, or the vital force, consisted in motion. Changes are continually going forward in the living body; physical forces are always striving for the equilibrium; the matter set in motion by them finds its centre of gravity--its point of rest. Force is nothing more than the expression of the casual account of natural laws; and if facts do not accord with our laws, we have either formed false opinions, or have imperfectly investigated the different circumstances under which they were exhibited. Within the past few years the science of toxicology, as de- veloped by the German and French chemists, has attained an accuracy which is surprising, when we contemplate the crude state it was in fifty years ago. But rapid as has been its pro- gress, there has suddenly arisen a barrier to its advance, more more formidable than any it had to meet before. Friedberg and Ritter mournfully acknowledge that the day has not yet arrived when we can detect the difference between dried human and ox blood. A few entuusiasts have claimed a peculiar oder to different kinds of blood; but these tests stood on so slender a foundation, and required an almost hyper- excited nose to detect them, that no conscientious expert will, for one moment, depend on it for convicting the criminal. The microscope, with its polarizing prism, is not able to distinguish between the most of domesticated animal's blood and that of man, after it has been dried any length of time. We are not able at the present day to detect absorbed alka- loidal poison, and this is the fact forming the subject of this essay, and to which I wish most particularly to call your atten- tion. There can be no doubt that these powerful agents, of which strychnia and morphia are the types, are absorbed into the blood, and diffused throughout the system like other poisons. There seems to be a want of unity in the statements relative to their deposition in the viscera, and their subsequent elimina- tion. M. Stats, in 1847, announced the discovery of the alka- loid in the tissues; but it is questionable whether this was not some portion of the nicotine which had beeu imbibed rather than absorbed. Referring to his process, with which all analytical chemists are familiar, he says he has separated strychnia and brucia from nux vomica, veratria from extract of veratrum, emetina from extract of ipecac, colchicin from wine colchioum, hyoscoamia from extract of henbane, and atropia from extract of belladonia. Some of the poisons mentioned here will destroy life--the fraction of a grain. Mr. Morson, of England, prepares aconitine, of which 1-144 of one grain is the full dose, and says that perhaps the 1-50 would prove fatal to an adult. Where is the analytical chemist who could separate, in quantity enough to give reliable colour test, and obtain crys- tals, visible even with the strongest microscope, thus 1-50 portion of a grain after it has been thoroughly transfused through twenty-eight pounds of blood, and all the tissues and organs of the body?* He who has this power can detect, and separate, and weigh the specific poison of rabies or of the rat- tlesnake, and could justly be classed as a rival of Omnipotence itself. Among numerous cases of poisoning by opium or its alkaloids which have fallen to my lot to examine and depose on, I cannot conscientiously say that I ever detected absorbed morphia.* The same remark will apply equally to strychnia, and I cannot see how some men will state definitely they can separate absorbed strychnia, but have never dared to undertake the task; knowing that the patient dies from the poison absorbed, they, while claiming they can detect and separate absorbed poison, contented themselves with extracting the contents of the stom- ach. When we look back, we find that up to May, 1856, as regarded the detection and separation of strychnia, chemical science was a blank. In no once instance before this had strychnia been obtained from the tissues of the corpse, and in the greater number of cases, it had not even been found in its unabsorbed state in the stomach. With respect, therefore, to the separation of the vegetable poisons, from the blood and tissues, the results are very unsat- isfactory. We look in vain in the treatises of Orfila, Kopp, Christison, and in the more recent works of Gauttier, Flandin, Casper, Otto of Braunschweig, Rocker, for any instance in which they claim absorbed strychnia to have been detected either in the human being or in animals; and, in this particu- lar, strychnia is but a type, for the same remarks hold good of other alkaloids. Dr. Harly, of University College, examined the blood of a dog killed by the 1-12 of a grain of acetate of strychnia injected into the jugular vein. The blood, after the death of the dog, gave no evidence of strychnia. Mr. Iloasly, of Chel- tenham, examined the blood and tissues of a dog which he poisoned with two grains of strychnia, and could not detect its presence. Dr. De Vry, of Rotterdam poisoned a dog with nitrate of strychnia, introduced into a 'wound, and after its death, he examined four ounces of blood, but not the least trace of strychnia was detected. In another case, in which a dog was poisoned in four days by half a grain of strychnia in divided doses, the chemical analysis led to a negative conclu- sion, not only in the blood and tissues but in all parts of the body. Dr. Crawcour, of New Orleans, gave a rabbit half a grain of strychnia; the animal died in half an hour. No trace of the poison was found in any part of the body. In a case of poisoning which occured to Dr. Geoghegan, of Dublin, in 1856, thirty ounces of urine, which had passed the patient from the fifty to the thirty-first hour, when carefully analyzed, did not yield any trace of strychnia. A case of great interest bearing upon this subject occurred to Mr. Wilkins, of Newport, in the Isle of Wright, in February, 1857. A gentleman died in six hours after taking about three grains of strychnia for the pur- pose of self-destruction. The long period he survived was most favorable for the diffusion and deposition of the poison. The blood and heart were examined by Dr. Taylor and Mr. Scanlan, portions of the liver and lungs were examined by Dr. Christi- son and Dr. Douglas Maclagan, of Edenburgh, and one kidney was examined by Dr. Geoghegan, of Dublin. The result was, no trace of absorbed strychnia was detected in any one part. In reference to the detection of other alkaloids in an absorbed state, there is an absence of facts. That they enter the blood by absorption is placed beyond a doubt; but whether, when there, they are partially changed, or deposited unchanged in the organs, has not yet been satisfactorily determined by ex- periment. Dr. De Vry has made recently experiments on the alkaloids, and arrives at the conclusion that that part of the alkaloid which acts mortally is decomposed in the living body. The examination of a large number of eases in the human sub- ject can alone determine perfectly this most important point in toxicology. Be that as it may, we are absolutely certain of a failure in attempting to detect the poisonous alkaloid atropia in the blood, if administered by hypodermic injection, as it would not require more than one-half a grain to prove fatal. Analytical chemistry, which has, up to this time, occupied so prominent a position, and been so ably associated with forensic medicine, is now perfectly powerless. She cannot solve this problem. There may come a time when more accurate methods and more delecate reagents may lead us to a satisfactory solution of it. Heretofore she has been the Nemesis which pursued, with out- stretched grasping hand, the murderer. That hand has been paralyzed by this bold application of principles of chemical physiology in the treatment of disease. The only means now of detection will lie in the testimony of the physician of the symptoms observed by him, at the bedside of the dying person.* Synthesis is far ahead of analysis, and we must admit that this is a problem of great importance, and to which the atten- tion of toxicologists should be turned. For the present we must say, as we stand grouping on the confines of mortality, and straining our powers to discover in the broad, measureless eternity some means of controlling the moral effect of this fact, and some law which may lead us to processes of detection, that just now we realize how hopeless the human mind is, how utterly futile has been its attempt to discover a mode of detec- tion. In future many a throbbing heart will suddenly cease, and no eye but God's be able to detect the murderer. For the present too much weight cannot be given to the testimony of medical witnesses at the bedside; if that is not had, and no physician was uear at the time of death, we are cast to drift upon an unexplored and perhaps a shoreless sea. Medical testimony now become all-important, and chemical testimony wanes in value, for no satisfactory results can be obtained. Juries -will now, more than ever, be dependent upon circumstantial evidence. Mortifying in the extreme as it is to our professional pride, stripped of professional honors in medico-legal investigations, the chemist and toxicologist now, if never before, realize the truth that comes floating to us on the dying breath of La Piace --"What we know is little, and what we are ignorant of is immense."--Proc. Amer. Pharm- Assoc. *Equals the 1-9800000 of a grain, assuming only the blood contains it. If diffused through the whole body, allowing 128 pounds for tissues, it would then be reduced to the 1-44800000. *In the case of a woman who committed suicide at one of our hotels and whose stomach was handed me immediately after death, I was able to separate only two grains, when she had actually taken ten grains. Again, in the case of a homoeopa- thic physician who gave solution of morphia, I detected the 1-8 of a grain in a teaspoonful of the solution, and could only get a colour test for morphia from the stomach. *There is just reason to hope for good results, from analysis, by the spectroscope. Bunsen discovered, in this way, the new metal Caesium in matter weighing only 1000th part of a grain. --Ed.

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THE CINCHONA TREE. On motion of Dr. Atkinson, the President was directed to appoint a committee to memorialize Congress, relative to the cultivation of the cinchona tree in this country.

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PAPERS PRESENTED. The Secretary presented the following named papers, which were referred to appropriate sections: 1. Observations on the Diseases of the Heart, as seen in Mil- itary Service from 1861 to 1865, by M. K. Taylor. 2. Novel Case of Lithotomy, by Dr. Edward Whinney, of Iowa. 3. Report on Ligature of the Subclavian Artery,' by Dr. Parker. 4. A communication from Chicago, informing the Association that during 1866, two members of the profession, named, had been expelled from their local Medical Society, for violation of tfie Code of Ethics. 5. A communication proposing that no person who is not a member and .supporter of a local Medical Society, where such a one exists, shall be eligible to membership in the American Medical Association. This being virtually an amendment to the Constitution, it was laid over for one year.

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CONVENTION OF TEACHERS OF MEDICAL COL- LEGES IN THE UNITED STATES. In pursuance of a call of a Committee appointed by the American Medical Association, at its last session, held in Bal- timore, May 3d, 1866, delegates from most of the medical in- stitutions of the country met Friday morning, May 3d, at 10 o'clock in the forenoon, in the faculty-room of the Medical College of Ohio. Professor Davis, of Chicago, Chairman of said Committee, called the meeting to order, and, after stating its object, pro- posed with a view to facilitate a permanent organization, the appointment of a temporary Chairman and Secretary. This proposition being accepted, Prof. A. Stills, of Philadelphia, was elected temporary Chairman, and Prof. G. C. E. Weber, of Cleveland, Ohio, Secretary. Prof. Davis, of Chicago, Prof. Donaldson, of Baltimore, and Prof. Blackman, of Cincinnati, were appointed a Committee on Credentials. The following-named gentlemen were approved as delegates from their respective colleges:-- A Stilld, from the University of Pennsylvania; S. D. Gross, from Jefferson Medical College, Philadelphia; F. Donaldson, from the University of Maryland, Baltimore; F. Howard, from Georgetown Medical College, Washington City; James M. Holloway, from University of Louisville, Ky.; A. Hammer and A. J. Steele, from Humboldt Medical College, St. Louis; J. N. McDowell, from Missouri Medical College, St. Louis; J. C. Hughes and M. K. Taylor, from the Medical Department of Iowa University, Keokuk; W. H. Byford and N. S. Davis, from Chicago Medical College, Chicago; A. B. Palmer, from the Medical Department of University of Michigan, Ann Arbor; Alden March, from Albany Medical College, N.Y.; A. B. Pal- mer, from Berkshire Medical College, Pittsfield, Mass.; G. C. E. Weber, from Charity Hospital Medical College, Cleveland; Francis Carter, from Starling Medical College, Columbus; Geo. C. Blackman and G. C. Comegys, from Medical College of Ohio; Geo. Mendenhall and E. B. Stevens, from Miami Medi- cal College, Cincinnati; B. L. Lawson and -- Read, from Cincinnati College of Medicine; and T. M. Logan, from Tol- land Medical College, San Francisco, Cal. Prof. Stills, of Philadelphia, was chosen permanent Chair- man, and Prof. Weber, of Cleveland, Secretary. Profs. Holloway, of Louisville; Davis, of Chicago; Black- man, of Cincinnati; and March, of Albany, were appointed a committee to report on the order of the different subjects which were to occupy the attention of the Convention. After which the Convention adjourned to 4 o'clock P.M. first day--Afternoon Session. The Convention was called to order at 4 o'clock P.M. Dr. N. S. Davis, from the committee to present a proper order of business, reported the following distinct propositions for the consideration of the Convention:-- "1. That every student applying for matriculation in a Medical College, shall be required to show, either by satisfac- tory certificates, or by a direct examination by a committee of the faculty, that he possesses a thorough knowledge of the com- mon English branches of education, including the first series of mathematics and the natural sciences, and the certificates pre- sented, or the results of the examinations thus required, be regularly filed, as a part of the records of each Medical College. "2. That every medical student be required to study not only three full years, but also to attend three regular annuaj courses of medical college instruction before being admitted to an examination for the degree of Doctor of Medicine. " 3. That the minimum duration of a regular annual lecture term, or course of medical college instruction, shall be five cal- endar months. "4. That every medical college shall embrace in its curric- ulum at least thirteen professorships, including substantially the following branches, namely: Descriptive Anatomy, Physiology and Histology, Inorganic Chemistry, Materia Medica, Organic Chemistry and Toxicology, General Pathology and Public Hygiene, Surgical Anatomy and Operations of Surgery, Med- ical Jurisprudence, Practice of Medicine, Practice of Surgery, Obstetrics and Diseases of Women, Clinical Medicine and Clin- ical Surgery. That these several branches shall be divided into three groups or series, corresponding with the three years required for medical study. The first, or freshman series, shall embrace Descriptive Anatomy, Physiology and Histology, Inor- ganic Chemistry, and Materia Medica. To these, the attention of the student shall be mainly restricted during the first year of his studies, and on them he shall be thoroughly examined by the proper members of the faculty at the close of his first course of medical college instruction, and receive a certificate indicating the degree of his progress. The second, or junior series, shall embrace Organic Chemistry and Toxicology, Gen- eral Pathology, Public Hygiene, Surgical Anatomy and Opera- tions of Surgery, and Medical Jurisprudence. To these, the attention of the medical student shall be directed during the second year of his studies, and on them he shall be examined at the close of his second course of medical college instruction, the same as after the first. The third, or senior series, shall embrace Practical Medicine, Practical Surgery, Obstetrics and Diseases of Women, with Clinical Medicine and Clinical Sur- gery in a hospital. These shall occupy the attention of the stu- dent during the third year of his medical studies, and at the close of the third course of medical college attendance, he shall undergo a general examination in all the departments, as a prerequisite for the degree of Doctor of Medicine. "The instruction in the three series of branches is to be given simultaneously, and to continue throughout the whole of each annual college term; each student attending the lectures on such branches as belong to his period of progress in study, in the same manner as the Sophomore, Junior, and Senior classes each pursue their respective studies simultaneously throughout the collegiate year, in all our literary colleges. "5. That the practice of selling individual tickets by mem- bers of medical college faculties should be abolished, and, in place of it, each stndent should be charged a specified sum for each annual course of medical college instruction; the sum being the same for each of the three courses before graduating; and any student or practitioner who has attended three full courses in any one college, shall be entitled to attend any sub- sequent course or courses in that college gratuitously. The fees paid for each annual course of college instruction should be paid to the Treasurer of the college, and subsequently dis- tributed to each member of the faculty, at such time and in such proportion as the Trustees and Faculty of each college shall determine. "6. That inasmuch as the maintenance of an efficient med- ical college requires a large expenditure of money annually, and inasmuch as there is no reasonable hope of adequate endowrments from the several State governments, the exaction of a just and reasonable annual lecture fee is a necessity with which all medical colleges should comply, and that $105 should be the minimum fee for each regular annual course of instruc- tion in any medical college in the United States." The first proposition was taken up and discussed by Profes- sors Davis, Gross, Comegys, McDowell, Hammer, Taylor, and Palmer, and with an amendment, so as to strike out the words "natural sciences," and add "sufficient knowledge of Latin and Greek to understand the technical terms of the profession," it was adopted. The Convention then adjourned, to meet at 9| o'clock Sat- urday morning. second day--Morning Session. On Saturday, 4th inst., the Convention was called to order by the Chairman, Professor Stills. The minutes of the preced- ing session were read and adopted. The Chair then announced that the next business in order was the discussion of Section 2 of the Report of the Committee on the order of Business, which reads as follows:-- "That every medical student be required to study three full years, including three regular annual courses of medical col- lege instruction, before being admitted to an examination for the degree of Doctor of Medicine." Professor Gross, of Philadelphia, moved to amend, so as to insert "four" after study, instead of "three." Remarks were made by Professors Gross; Hammer, of St. Louis; Davis, of Chicago; Palmer, of Michigan; and McDow- ell of St. Louis. The Convention then suspended the rules, for the purpose of allowing Professor Davis to introduce the following resolution: "Resolved, That on all distinct propositions under the con- sideration of this Convention, no member shall speak more than once, until all other members have spoken who "wish to speak." Adopted. Prof. F. Howard, of Washington City, moved to amend, by inserting "not less than three years," instead of "three full years." Lost. Prof. Gross' amendment was then adopted. On motion of Prof. Gross, the entire section, as amended, was unanimously adopted. Prof. Hammar moved to take up for consideration Section 4, prior to Section 3. Lost. Section 3 was read, viz., "That the minimum duration of a regular annual lecture term or course of medical college instruc- tion shall be five calendar months." Prof. Gross moved to amend by inserting "six" in place of "five calendar months." Carried. Section 3, as amended, was then adopted. Section 4, being next in order, came up for discussion. Prof. Gross moved to discuss the different parts of this section separ- ately. First, that relating to the different branches recom- mended to be taught in the schools. Second, the number of professorships. Third, the division of studies. Adopted. Prof. Hammar moved to add to the different branches, Nat- ural Philosophy and Pathological Anatomy. Prof. Donaldson, of Baltimore, moved to act upon these prop- ositions separately. The vote on the addition of Natural Philosophy being taken, it was rejected. The amendment adding Pathological Anatomy was carried. Prof. Byford, of Chicago, moved to amend by including Dis- eases of Children. Carried. On motion, the Convention then adjourned to meet at 4 o'clock, P.M. second day--Afternoon Session.. The meeting having been called to order by the chairman, the second part of Section 4 was called up for discussion. Prof. Gross moved to amend by inserting after the words "following branches," "to be taught by not less than nine pro- fessors." Carried. Remarks were made by Professors Gross, Palmer, Davis, Hammar, Howard, and Taylor. The third part of Section 4, referring to the division of stud- ies, was next considered. Prof. Davis moved to amend, by making that part read as follows:-- "That these several branches shall be divided into three groups or series, corresponding with the three courses of medi- cal college instruction required. The first, or Freshman series, shall embrace Descriptive Anatomy and Practical Dissections, Physiology and Histology, Inorganic Chemistry, Materia Medica and Therapeutics. "To these, the attention of the student shall be mainly re- stricted during his first course of medical college instruction, and in these he shall submit to a thorough examination by the proper members of the Faculty at its close, and receive a cer- tificate indicating the degree of his progress. "The second, or Junior series, shall embrace organic Chem- istry and Toxicology, General Pathology, Pathological Anatomy and Public Hygiene, Surgical Anatomy and Operations of Sur- gery, and Medical Jurisprudence. To these, the attention of the medical student shall be directed during his second course of medical college instruction, and in them he shall be examined at the close of his second course, in the same manner as after the first. "The third, or Senior series, shall embrace Practical Medi- cine, Practical Surgery,' Obstetrics, and Diseases peculiar to Women and Children; with Clinical Medicine and Clinical Surgery in a hospital. These shall occupy the attention of the student during his third course of medical college instruction, and at its close he shall be eligible to a general examination on all the branches, as a prerequisite for the degree of Doctor of Medicine. The instruction in the three series of branches is to be given simultaneously, and to continue throughout the whole of each annual college term; each student attending the lec- tures on such branches as belong to his period of progress in study, in the same manner as the Sophomore, Junior, and Sen- ior classes each pursue their respective studies simultaneously throughout the collegiate year, in all our literary colleges." After a prolonged debate, in which Professors Gross, Palmer, Blackman, Davis, and Taylor participated, the motion of Prof. Davis prevailed. Prof. Davis then moved the adoption of the entire section as amended. Carried. Section 5 was then taken up, and, upon motion of Professor Palmer, was laid on the table. Section 6, being in order, was read, but, on motion of Prof. Gross, was also laid upon the table until Monday morning, 6th inst. On motion of Prof. Davis, the Convention then adjourned to meet at 10 A.M., on Monday morning. third day--Morning Session. The meeting was called to order by Prof. Stills, at 10 o'clock A.M. The minutes of the previous session were read and approved. The Committee on Credentials announced Dr. T. M. Logan, of Sacramento, California, as an authorized delegate from the Faculty of the Toland Medical College of San Francisco. Prof. Gross moved to reconsider parts of Section 4, relating to the branches to be taught in medical colleges. Prof. ITammar moved to suspend the rules for that purpose. Carried. Prof. Gross moved to amend part 1st, Section 4, by inserting the words "Medical Ethics" after the words "Medical Juris- prudence. Prof. Palmer moved the adoption of the amendment. Carried. Prof. Comegys moved the reconsideration of Section 1. After suspension of the rules, this motion was adopted. Prof. Comegys moved to amend Section 1, by inserting "El- ements of Natural Sciences" after the word "Mathematics." Carried. Prof. ITammar moved the adoption of the whole section as amended. Carried. Section 6 was then considered. On motion of Prof. Donaldson, it was laid on the table. Prof. Palmer then introduced the following resolution:-- Resolved, That every medical college should immediately adopt some effectual method of ascertaining the actual attend- ance of students upon its lectures and other exercises, and at the close of each session or of the attendance of the student a cer- tificate, specifying the time and the courses of instruction actu- ally attended, should be given; and such certificate only should be received by other colleges as evidence of such attendance." The resolution was adopted. Prof. Davis moved the adoption of all the sections as amended. Prof. Gross moved to transmit a copy of these sections, as adopted by this Convention, certified to by its officers, to the American Medical Association, at its next session. Prof. Davis then introduced the following resolution:-- "Resolved, That a committee of five be appointed by the President, whose duty it shall be to present the several propo- sitions adopted by the Convention to the trustees and faculties of all the medical colleges in this country, and solicit their def- inite action thereon, with a view to the early and simultaneous practical adoption of the same throughout the whole country, And that the same committee be authorized to call another convention, whenever deemed advisable." The Chair appointed the following gentlemen that committee: Profs. Davis, of Chicago; Donaldson, of Baltimore; Gross, of Philadelphia; March, of Albany; Blackman, of Cincinnati. The Chairman then introduced Dr. Vattier, President of the Cincinnati Academy of Medicine, who invited the members of the Convention to be present at the opening of the Academy in the evening. Prof. March moved to accept the invitation. Carried. On motion of Prof. Davis, a vote of thanks was returned to the Chairman and Secretary of the Convention, for the effi- ciency with which they have discharged their duties, and to the Faculty of the Ohio Medical College for the use of their hall. The President returned his thanks to the members of the Convention, in a neat and appropriate speech. Prof. Stevens moved that a formal written thesis on some professional topic shall still be regarded as one of the indispen- sible requirements of the doctorate. Remarks were made by Professors Comegys, Stevens, and Donaldson. < Prof. Davis then rose, simply to suggest whether there was not some danger of entering upon the consideration of proposi- tions involving details that might unnecessarily complicate the great leading object for which we have been laboring. Whether the time-honored and universal custom of requiring the medical students to write a thesis should be insisted on or not, would have but little bearing on the great principles involved in the revision of our system of medical education. If the standard of preliminary education which we have here adopted should be carried into effect, it would remove one of the objects for which the writing of a thesis was originally demanded. Yet, he said, it was desirable to retain the practice, if for no other purpose than to encourage every student in the habit of expressing his thoughts on paper. But the great and all-important object of this Convention was simply to place the system of medical edu- cation in this country upon sound educational principles, by erecting a standard of preliminary education, by increasing the period of study, by adding to the college courses, and by deter- mining a rational order of study. This we have now done, so far as this Convention is concerned, by the harmonious adop- tion of the five propositions already passed upon. And he earnestly suggested whether we had, not better stop here, and devote the remainder of our time to the work of devising the most efficient means to secure the adoption and simultaneous practical execution of the provisions already agreed upon by all the colleges of our country, and leave all minor matters of detail to be determined as time and circumstances should indi- cate in the future. Thereupon, on motion of Prof. Hammar, the Convention adjourned, subject to the call of the Committee. The following is a correct copy of the several propositions as finally adopted by the unanimous vote of the Convention ;-- "Resolved:-- 1st. That every student applying for matriculation in a Medical College, shall be required to show, either by satisfac- tory certificate, or by a direct examination by a Committee of the Faculty, that he possesses a thorough knowledge of the common English branches of education, including the first se- ries of mathematics, the elements of natural sciences, and a suf- ficient knowledge of Latin and Greek to understand the techni- cal terms of the profession; and that the certificate presented, or the result of the examinations thus required, be regularly filed as a part of the records of each Medical College. 2d. That every Medical Student shall be required to study four full years, including three regular annual courses of Medi- cal College instruction, before being admitted to an examination for the degree of Doctor of Medicine. 3d. That the minimum duration of a regular annual lecture term, or course of Medical College instruction, shall be six calendar months. 4th. That every Medical College shall embrace in its cur- riculum the following branches, to be taught by not less than nine Professors, namely:--Descriptive anatomy, including dis- sections ; physiology and histology; inorganic chemistry, mate- ria medica, organic chemistry, and toxicology; general path- ology, therapeutics, pathological anatomy, and public hygiene; surgical anatomy and operations of surgery; medical jurispru- dence and medical ethics; practice of medicine, practice of surgery, obstetrics, and diseases of women and children; clini- cal medicine and clinical surgery. And that these several branches shall be divided into three groups or series, correspond- ing with the three courses of Medical College instruction re- quired. The first, or Freshman Series, shall embrace descriptive anat- omy and practical bisections; physiology and histology; inor- ganic chemistry, and materia medica. To these, the attention of the student shall be mainly restricted during his first course of Medical College instruction, and in these he shall submit to a thorough examination, by the proper members of the Faculty, at its close, and receive a certificate indicating the degree of his progress. The second, or Junior Series, shall embrace organic chemis- try and toxicology; general pathology, pathological anatomy, therapeutics, and public hygiene; surgical anatomy and opera- tions of surgery; medical jurisprudence and medical ethics. To these, the attention of the medical student shall be directed during his second course of Medical College instruction, and in them he shall be examined, at the close of his second course, in the same manner as after the first. The third, or Senior Series, shall embrace practical medicine; practical surgery; obstetrics, and diseases peculiar to women and children; -with clinical medicine and clinical surgery in a hospital. These shall occupy the attention of the student dur- ing his third course of College instruction, and at its close he shall be eligible to a general examination for the degree of Doctor of Medicine. The instruction in the three series is to be given simultane- ously, and to continue throughout the whole of each annual College term; each student attending the lectures on such branches as belong to his period of progress in study, in the same manner as the sophomore, junior, and senior classes, each pursue their studies simultaneously throughout the collegiate year, in all our Literary Colleges. 5th. That every Medical College should immediately adopt same effectual method of ascertaining the actual attendance of students, upon its lectures and other exercises, and at the close of each session, of the attendance of the student, a certificate, specifying the time and the courses of instruction actually at- tended, should be given, and such certificate only should be received by other Colleges as evidence of such attendance. 6th. That a committee of five be appointed by the President, whose duty it shall be to present the several propositions adopted by this Convention, to the Trustees and Faculties of all he Medical Colleges in this country, and solicit their definite ction thereon, with a view to the early and simultaneous prac- ical adoption of the same throughout the whole country. And hat the same committee be authorized to call another conven- i on whenever deemed advisable."

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MEDICAL LITERATURE. Dr. Post, of New York, read a report on Medical Literature, in which he mentioned among other publications of the year, the Report of the New York Board of Health, in regard to Cholera. k Dr. Sayre found fault with the report in that it dignified the production of the New York Board of Health with the name of Medical Literature. He moved to strike out that portion. The motion was not seconded, and the report was referred for publication. The Association then adjourned until 9 o'clock to-morrow morning.

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REFORM IN MEDICAL COLLEGES. Dr. Sayre, of New York, offered the following: Resolved, That this Association, most heartly approving the whole action of the Convention of Medical Colleges, urge its practical adoption on all the Medical Colleges in the country. Dr. Post, of New York, wished to offer some change in the course of instruction proposed. Dr. Davis cut the gentleman off by saying that the College to which he was attached had been invited to be present and take part in the proceedings of that Convention, but had not seen fit to do so. He could at the next meeting of that Convention offer any amendment he chose, but this Association has no power to act in the matter. Dr. C. A. Lee, of Buffalo, though not present at the Medical College Convention, approved of all that was done. He had for many years, as a teacher in a Medical College, contemplated just such changes as had been recommended. The resolution was then adopted.

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MEDICAL STATISTICS IN TIIE ARMY. . Dr. Benjamin Howard, of New York, offered the following preamble and resolutions: Whereas, There has been issued, and still remains in force, an official order from the Surgeon General of the United States Army prohibiting the communication of any medical or surgicial information, by any medical officer of the United States Army, to any person whatsoever, without special permission from the Medical Bureau at Washington; thus appropriating, as far as the official power of the Surgeon General can compass it, all the valuable experience and statistics of all medical men who have served in the various departments of the United States Army to the exclusive use of the Medical Bureau; and, Whereas, Under such arbitrary control an official report has already been made tending to create incorrect impressions on scientific questions of great practical importance to the profes- sion and to society; and, Whereas, It is important to the reputation of all men, who served during the war, that they have the opportunity of cor- recting such erroneous impressions by an examination of the original records; therefore, be it Resolved, That it is the opinion of this Association that the monopoly now exercised by the Medical Bureau over the medical and surgicial records of the war, is contrary to the genius and catholic spirit of our profession, and obstructive to the highest interests of science and humanity. Resolved, That the Secretary of War, or other proper author- ities, be requested to direct that the original records of the medical and surgicial history of the war be rendered accessible, on certain regular days of each month, for purposes of scientific investigation, to all medical men who have served as such in the army of the United States. Dr. Woodward, of the U. S. Army, and occupying some position in the Surgeon General's office, replied curtly to the proposition and speech of Dr. Howard, charging him with ven- tilating his private griefs in such a way as to reflect upon the honest and faithful performance of duty by Government officers. The simple fact was, that in the routine of duty of the office there were fifty clerks engaged in examining the reports refer- red to, investigating the claims of officers, soldiers, and widows of the same, for pensions, etc., and in making up the medical report for publication. To admit any portion of the public to these documents would retard the performance of duty toward these needy claimants. He therefore moved to lay the pream- ble and resolutions on the table, which was agreed to almost unanimously.

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ENTERTAINMENTS AND RECEPTIONS. Dr. Murphy also announced, besides the entertainment last evening, the following

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REPORT ON INSANITY. Dr. C. A. Walker, of Boston, read the report of Dr. J. Ray, of Providence, R. I., on insanity. It was an able and interest- ing paper. Dr. Chipley, of Lexington, Ky., oifered some remarks in vindication of the Superintendents of Insane Asylums, with reference to their connection with this association. He re- ferred to the fact that there were five such Superintendents present, who were a larger proportion of their class than the representatives of any other class of the medical profession present. The report of Dr. Ray was referred to the Committee of Publication.

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ARTICLE XXI. REPORT ON INDIGENOUS BOTANY. BY ---MASSEY, M. D. Read before the Eseulapian Society, October, 1866. Mr. President and Fellows of the Esculapian Society : Gentlemen,--As chairman of your committee on Indigenous Botany, I feel it my duty to present a report--a task however which I feel myself utterly incompetent to perform under the most favorable circumstances. And when I remind you of the very elaborate and interesting report of my highly esteemed friend Dr. Miller on this subject, at the last meeting of this society, I cannot fail to excite your deepest sympathies and commiseration on my behalf. It will not therefore, be my aim to take a very extensive survey of this field of enquiry, but I shall confine my remarks to but a few species of a single genus of the flora of our beauti- ful country. The first to which I shall call your attention is the Asclepias Cornuti. Asclepias is from the Greek of Esculapius, fabulous god of medicine and physicians. It belongs to the natural order of Asclepiadaceae, and all of its species as far as I know, to Pen- tandria Digynia of the artificial system of Linnaeus. The distinguishing characteristics of this genus are that the leaflets are cucullate or hooded, with an averted horn-like pro- cess at the base, curved toward the stigma. Six species I know from observation, to be indigenous to this State and County, namely, A. Cornuti, A. Tuberosa, A. Incar- nata, A. Purpurasceus, A. Obtusifolia, and A. Sullivantii. The first three of which are ranked in the secondary list of medic- inal substances in the U. S. Dispensatory. The species under consideration is the A. Syriaca of the U. S. Dispensary, or common silk-weed, a very common, coarse, lac- tescent perennial plant, growing along lanes and hedges, pre- ferring a rich sandy soil. The stem is simple, stout, from three to five feet high ; leaves oblong-ovate, short-petiolate, mucronate, downy beneath, pedi- cels shorter than the leaves, densely many-flowered ; hoods of crown ovate obtuse, not longer than the uncinate horn ; corolla lobes ovate, reflexed ; leaves five to eight inches long, by two to three inches wide ; vcinlets at nearly right angles with mid-vein ; peduncles stout, between petioles, bearing a globular umbel of about a hundred greenish purple flowers, few of which prove fruitful; folicles sprinkled with soft warty spines, full of seeds with their long pappus or silk. It flowers in July and August. The stem and leaves give out a milky juice when wounded ; hence one of its names, milk- weed. This juice has a sub-acrid taste and an acid reaction. Dr. C. List found the chief solid ingredient of the juice to be a pe- culiar crystaline substance of a resinous character, closely allied to lactucone, and which he proposes to call asclepione. The juice is coagulated by heat, filtered, then digested with ether, which dissolves the asclepione and yields it by evapora- tion. Dr. Shultz found 80 parts of the juice to contain 69 of water, 3.5 of a wax-like fatty matter, 5 of caoutchouc, and 0.5 of gum, 1 of sugar with salts and acetic acid, and 1 of other salts. It is highly probable that the asclepione of Dr. List is the aggregate of the fatty and gummy matter of the juice soluble in ether, as nine parts out of eleven were shown to be of this char- acter by Schultz. These analyses throw little or no light on the medicinal prop- erties of the juice, if indeed it is possessed of any. The root however is the medicinal part, the juice of which is not milky. Dr. Richardson of Mass, found the root to possess anodyne properties. He gave it with advantage to an asth- matic patient, and in a case of typhus fever attended with cat- arrh. In both instances it appeared to promote expectoration, to relieve pain, cough and dyspnoea. He gave a drachm of the powdered bark of the root in divid- ed doses during the day, and employed it also in strong infu- sion. Dr. Thomas, of Rocky Springs, Miss., stated in a letter to one of the authors of the U. S. Dispensatory, that he had em- ployed the root in Scrofula with great success, and in Dyspep- sia with advantage. He found it cathartic and alterative, but .observed no anodyne property. He was induced to try it, hav- ing noticed that it was much used by the planters in scrofula and other diseases; and by the recommendation of Dr. McLean of Kentucky, who had employed it for twenty years in scrofula with most satisfactory results. Dr. McLean also speaks very highly of it as an alterative in hepatic affections. He is however of opinion that it might be possible that he was using a different species from that described in the U. S. Dispensatory. The doubt expressed by Dr. McLean, as to the species used by him might, at first, seem to invalidate his testimony in regard to the virtues of this species of asclepias; but when we remark the different appearance of different specimens, grown in differ- ent soils--and at the same time the impossibility of confounding it w'ith any other known species--we are inclined to the opinion that Dr. McLean -was confused by the first of the above facts,, and that he was using the asclepias cornuti. Dr. R. S. Cantiiorn, of Richmond, Va., used it successfully in several cases of intermittent fever; and it is considered by him a valuable anti-periodic; he gave from four to six grains of the powdered bark, in form of pill, every two or three hours, augmenting the quantity to three times that dose, two or three times before the paroxysm. I cannot speak as to its virtues as an anti-periodic, never having used it to fulfill such an indication; but as an alterative in scrofula, and as a gentle tonic- in dyspepsia, I believe it to be a valuable remedy, and worthy of the attention of the profes- sion. I think it may reasonably be-expected to do good in cachectic diseases, generally attended with torpor of the bowels, which it has a tendency to regulate; this, I believe it effects, in part at least, by giving tone to- and stimulating the muscular coat, and in part by exciting a flow of bile, and other secretions, into the alimentary canal. I have used it in strong decoctions; half ounce of the dried root to one pint of water--to be taken during the course of the day, and continued for a considerable period of time, unless it acts too much upon the bowels, in which case the dose should be reduced. I next call your attention to asclepias tuberosa; this is the butterfly weed, or pleurisy root; it differs from all other species of asclepias, in not possessing a milky juice. The stem is ascending, hairy, with spreading branches at the top; leaves alternate, oblong-lanceolate, often sessile, umbels numerous, forming a large terminal corymb; hoods bright orange, oblong, narrow, with slender sub-falcate, sub-erect horns. It inhabits dry fields and meadows in the Middle, Western, and Southern States. The root is large, fleshy, tuberous, sending up numerous stems two feet high and very leafy; leaf at top only, quite sessile, acute; obtuse at base, two to four inches long, by half to one inch wide; petals and crown of equal length; follicles branco- late-pointed, containing long, silky down; it flowers in August. There is a variety, growing mostly in the Southern States, the stem of which is decumbent, which has been raised to the rank of a species, by some botanists, under the name of A. De- cumbens; the root is the medicinal part, which was brought into popular use by the Indians, who used it in a variety of diseases. Siioeff first brought it to the notice of the profession. It is ranked, by Prof. Dunglison, as a stimulating diaphor- etic. He, however, has but little to say about it, and appears to know less; as it certainly neither increases the heat of the surface nor accelerates the pulse. I think that no one, who has any experience with it, will deny its powerful diaphoretic properties. It appears to act directly on the sudorifie porous glandula of the skin; having no direct sedative action on the heart or vascular system; neither does it act by inducing nausea; for, although it is slightly nauseant in the recent state, it acts as certainly and as powerfully when dried. It acts also as a cathartic, when given largely, especially in the recent state. Dr. Griffith says that it is a valuable remedy in a variety of diseases, especially of the respiratory organs, and that there is ample testimony of its beneficial effects, if properly adminis- tered, in this class of cases. Dr. Chapman states that it is very certain and permanent in its action, and is well suited to excite diaphoresis in the forming stages of inflammatory diseases. It has been used with success in acute rheumatism; nor is it empirically prescribed in this painful disease; as our present knowledge of its pathology points plainly to the use of blood depurants and elimenatives; and when we take into account the fact, that the sudden suppression of the cutaneous transpi- ration is a most fruitful cause of this disease, we can easily com- prehend how active diaphoretics are likely to prove peculiarly useful. Dr. Lockwood states that when used in strong decoction or infusion, in the proportion of one ounce to a quart of water, (a tea-cup full of which should be taken warm every three or four hours,) it acts with as much certainty as a diaphoretic, as jalap does as a cathartic. It is also recommended, by Dr. Eberle Parker and others, in acute dysentery; and in cases where the skin is hot and dry, I believe it to be highly useful, in virtue of its diaphoretic properties; but I am inclined to the belief that it acts beneficially in this disease, independently of its sudorific properties--by, in some unknown way, modifying the action of the mucous mem- brane of the alimentary canal, as I believe it also does of the mucous lining of the bronchd. It is popularly esteemed in flatulent colic; hence one of its names, wind root; and I think there can be no doubt that it is gently tonic to the muscular coat of the stomach and bowels. I prescribed it in one case of typhod fever in which the skin was hot and dry and considerable tympanitic distention of the bowels; the patient could not take oil of turpentine in any way, on account of idiosyncracy: a pint of the decoction, as prepared above, was given ad libitum through the course of the day, and I was highly pleased with its effects; its use was followed by relaxation of the skin, a subsidence of the tympanites, and a general amelioration of all the symptoms. Of course other adjuvants were used, but I attributed the subsidence of the tympanites, and the diaphoresis to the asclepias. I would not be understood, however, to recommend it as a substitute for the oil of turpentine; especially where the altera- tive effects of the latter medicine on the ulcerated patches of the small intestines is desired; but cases may occur in which the oil cannot be administered, as that just narrated; under such circumstances, I would recommend the use of the remedy under consideration. Nor do I believe it to be entirely without alter- tive effects on the mucous membranes, as I have already hinted. Dr. Lockwood speaks very highly of its use in promoting the eruption in the exanthematous fevers; that it is useful in pro- moting the eruption in measles, I can testify from observation; it is also useful in this disease on account of the pectoral symp- toms that not unfrequently attend it. Indeed, it is in diseases of the respiratory organs that it ha<< enjoyed the highest reputation, as one of its names would indi- cate--pleurisy root. Dr. L. K. Williams, of Ohio, my former preceptor, was much in the habit of prescribing it in pneumonia, especially the typhoid variety. It appears to me to be much better adapted to the treatment of typhod pneumonia than ipicacuanha, on account of the de- pressing effects of the latter remedy; it is especially indicated when the skin is hot and dry. Sulphate of quinia, opium, or one of the salts of morphia, with the decoction of asclepias tuberosa were the remedies relied on in this form of pneumonia by Dr. Williams, as they are by myself: under this treatment copious diaphoresis is speedily brought about, and should be encouraged until the disease begins to decline; of course I do not speak of other adjuvants and ap- pliances, as I am not writing on pneumonia; but I have been thus particular in describing its use in this disease, as it is the one in which I would especially recommend it. Dr. Lockwood advises to gather the root about the first of October, cut in transverse slices, dry in the shade, pulverize and bottle; as found in the shops it is reduced to a coarse powder, pressed into cakes and enveloped in paper, each book containing one pound. Asclepias incarnate is the third and last species of asclepias that enjoys any reputation as a remedial agent. The stem is tall, and branching above ; leaves opposite, lan- ceolate, on short petioles, slightly tomentous; umbels numerous, erect, mostly terminal, often in opposite pairs; hoods ovate- oblong, with subfalcate ascending horns; found in wet places: three to four feet high with two hairy lines; leaves from four to seven inches long, by one-half to one and a-half inches wide, rather abrupt at base, tapering to a very acute point on petioles one-half inch long; corolla, purple or flesh-colored; flowers in July and August. The root is the medicinal part, and is esteemed by some to be analogous in remedial properties to asclepias syriaca. Dr. Griffith considers it a valuable cathartic and emetic; it has not, however, been sufficiently tested to determine its precise medicinal virtues. Dr. Tully, of New Haven, who has had an extensive experi- ence with our indiginous remedies, says that it may be adminis- tered with advantage in catarrh, asthma, rheumatism, syphilis, and verminous affections. The dose is from | drachm to a drachm of the powdered root: a more eligible form for administration is that of a fluid extract, which may be found in the shops; and is largely con- sumed by the Eclectic doctors who use it, as I am informed, in a variety of cachectic and glandular diseases in which an alterative impression is desired. I have had no experience with it myself; and I should not have called your attention to it, but for the fact that it belongs to the genus under consideration, and has had such valuable properties attributed to it by those who have used it. It grows in abundance in the swampy portions of this State; and any one who may desire to test its virtues may certainly do so by the aid of the botanical analysis above given, and the specimens I present you. The other species above-named may or may not possess valuable remedial properties; a fact which can only be known by actual and repeated experiment; and, judging from the in- disposition of the medical profession to verify the experiments of others, however encouraging they may be, it is not likely that we shall know until, by accident or otherwise, they are forced upon our attention. My friend, Dr. Miller, in his report called the attention of this society to an anonymous plant, the virtues of which I have determined to test, upon a suitable opportunity presenting itself. Believing that others were as favorably impressed as myself, will, I hope, be a sufficient apology for my giving the following botanical analysis: I refer to verbena bractiosa. Verbena or vervain (from the Celtic perfoen, to expel stone) belongs to the natural order verbenaceae: the species under consideration belongs to peutandria monogynia, of the artificial system: it is perennial; inhabits dry fields and roadsides of the Middle, Western, or Southern States. It is decumbent, branched, very hairy, leaves lacinate rugous; spikes terminal, thick, many-flowered; bracts, lance- linear, longer than the flowers, thrice longer than the calyx; whole plant eight to ten inches long; leaves from one to two inches long; flowers small, blue, blooms from May to September. Several species of verbena have enjoyed considerable popu- larity, both in this country and Europe. Its popular name, vervain, shows that it was formerly held in high estimation for the expulsion of stone. The verbena verticsefolia is esteemed by many as a powerful emmenagogue; the root being the part used in strong decotion. My friend, Dr. Miller, used the verbena bractiosa with marked success in a case of scrofula with amenorrhoea. I understand him, however, to recommend it especially in scrofulous complaints. Verbena hastata has also been used in scrofula: it is power- fully bitter, and may possess some tonic or alterative virtues which render it valuable in scrofulous diseases. Grrandvieiv, 111., Oct. Slst, 1866.

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ARTICLE XXII. MASTITIS AND ITS TREATMENT. By ROBERT S. ADDISON, M.D., 269 Milwaukee Avenue, Chicago. As it has at this day become very fashionable--I believe that is the right word to apply--for mothers to wean their children early; if, indeed, they nurse them at their own breasts at all, our attention has been, lately, more frequently directed to the treatment of mastits and mammary abscess than formerly. Regarding mastitis, in most instances we are not called upon to render relief until the breast has become painfully distended, and we find our treatment (which is directed mainly to the pre- vention of abscess,) of no avail, in a great many cases. Having, in my own practice, had this occur so often, after having made use of cathartics and alterants, and relying much upon the liniments and ointments, hitherto so much extolled, without obtaining' the desired and anticipated results, I have adopted a different mode of treatment, and one which has given me more gratifying results than those previously employed. I believe that the effects of liniments and ointments are counteracted by the friction employed in their application, and now never make use of them, but proceed as follows: If called before resolution has commenced, I begin with a saline cathartic, and direct my patient to avoid the use of fluid, as much as possible, and vegetables entirely, and make use of a diet composed of bread and meat, taken as dry as is endurable. In many instances, this general treatment alone is sufficient to relieve the mastitis. If, however, the breast has become painfully distended before I see the case, I supplement the foregoing treatment, by having an ordinary glass breast tube heated by immersing it for awhile in hot water, then, tightly closing the small orifice and cooling the large one until it can be comfortably borne upon the breast apply it over the nipple; then cover the tube with a cloth wrung out of cold water; and thus obtain easy and regular suction, which--repeated if necessary--entirely relieves the over-distended breast. Where I find the patient in humble circumstances, I direct the use of a common beer-bottle instead of an ordinary breast tube; but it is not so well borne, owing to the smallness of the orifice and the irregularity of the surface which comes in con- tact with the tender areola. March ll^h, 1867.

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GHiniral lUnurU. FROM THE LECTURES OF PROF. DAVIS IN THE MEDICAL, AND PROF. ANDREWS IN THE SURGI- CAL WARDS OF THE MERCY HOSPITAL. [Reported for the Examiner.] [The Lectures from which these "Notes" are made, being delivered before the Summer Class of the Chicago Medical College, necessarily contain much matter of a purely elemen- tary character. No attempt is, therefore, made to report them in full, as such information, for the majority of the readers of the Examiner, would be, it is presumed, supererogatory. The "Notes" are intended simply to comprise outlines of such cases as may possess sufficient importance, together with a rationale of the treatment or summary of operation, and such didactic hints as may seem valuable--aiming to be a practical elucidation of the treatment, medical and surgical, rather than a syllabus of the Lectures.--R.] SERVICE PROF. N. S. DAVIS, M.D., VISITING PHYSICIAN. Therapeutic Value of Tinct. Chloride of Iron and of the Sulphites in Treatment of Erysipelas.--2Etat. 41; American; occupation, carpenter; admitted for treatment, March 27th, laboring under a well-marked attack of facial erysipelas, the inflammatory stage having probably existed about forty-eight hours, although he had been complaining previously, and had taken some purgative medicine before his admission into the hospital. The febrile symptoms not being very urgent, and there being no evidence of cerebral congestion, he was ordered twenty-five drops of the tinct. chloride of iron {tincture ferri chloridi, Ph. U. S.), well diluted with sugar and water, every two hours during the ensuing twenty-four; after which, the in- terval was to be lengthened to three hours during the second day, and to four hours on the third day, when it was confidently anticipated the septic character of the disease would be entirely destroyed, and convalescence established. The sulphites of soda and lime would undoubtedly produce the same results as antiseptics--in fact, their efficiency in the treatment of erysipelas, as well as in all other of the large and important class of catalytic diseases, seems to depend almost exclusively, on their power to neutralize the blood-poison. The tinct. chloride of iron possesses this power to a great extent; but in addition to this, it is one of the most reliable tonics, and where not contra-indicated by a high degree of febrile excite- ment, by cerebral congestion, by such constitutional disturbance as is manifested by a strong, full, and frequent pulse, excessive heat of surface, and severe pain, we will find its use followed by a prompter convalescence, and fewer unpleasant sequelae, than by the use of alkaline sulphites. These latter would seem, from our clinical observations and experiments thus far, to be more especially useful in retarding or arresting septic or necremic changes in the blood; and where the indications point simply to such ends, the sulphites are val- uable agents. In the epidemic of erysipelas in this city, during the fall of 1863, in which many cases of an uncomplicated sthenic character occurred, they were found highly useful, and by their free exhibition, at an early stage of the disease, did much to cut short the period of its duration. Cardiac Disease--Post Mortem Appearance in.--The death of the subject of the clinique, reported in the February number of the Examiner, (page 107), gave an opportunity for an exam- ination of the pathological condition, which was duly presented to the class. Previous to his death, however, the attention of the class had been again called to him, and the hour pretty ful- ly occupied in the physical exploration of his chest; so that on the examination of the lesion, after death, the students were enabled to appreciate the value of the pathognomanic symptoms they had become familiar with through life. Post Mortem:--There was general serous infiltration of the areolar tissues, throughout the body; a moderate accumula- tion of serum in the peritonial and pleuritic cavities; and a completely oedematous condition of the left lung. The heart presented a rare and interesting combination of pathological changes. The mitral valve was thickened and indurated, and the opening through it moderately contracted. The tricuspid and semi-lunar valves were all natural in structure. The walls of the left ventricle were natural in thickness, but its' cavity is moderately elongated and pouched at the apex. The walls of the right ventricle were greatly hypertrophied, being in some places more than three-quarters of an inch in thickness. The columnae carnae were correspondingly increased in size, but the cavity of the ventricle was not materially altered in size or shape. The trunk and cardiac orifice of the pulmonary artery were so much dilated that the valves in the latter were insuffic- ient to close it. The full explanation of these pathological changes in the heart, and their relation to the general symp- toms, and physical signs presented before the death of the pa- tient, was made very interesting and instructive to the clinical class. Early Diagnosis of Phthisis.--P. McC., aet. 51, Irish; has been an inmate of the hospital some two or three weeks, suffer- ing from general debility, and unusually enfeebled cardiac action. His general appearance, at the time of his admission, suggested a suspicion of crude tuberculosis as being at the ori- gin of his troubles,--causing his debilitated condition, by imped- ing the functions of the lungs, diminishing the gross amount of assimilation, and causing an imperfect oxygenation of the blood, by which the vital properties of all the tissues were af- fected. Careful and repeated examinations, however, failed to detect any evidence of disease in the lung. Within the past few days a peculiarly foetid odor, such as is occasionally ob- served accompanying the existence of an old glandular abscess, has been detected; and auscultation and percussion now exhibit such departure from the normal standards, as to warrant pre- senting him before the class, as an example of incipient.tubercu- lar phthisis. In the infra clavicular region of the right side, there is to be found a prolongation of the respiratory murmur, --not rough or loud, or in any other wise changed, but simply a prolonged expiratory sound. There is also a slight dulness on percussion in this region, though very slight and requiring close attention to detect the change. When the patient speaks, there is also a diffused vibratory jar perceptible. Thus there exist evidences, both of impaired capacity for air, and of in- creased density of structure in the upper part of that lung. In the cardiac region auscultation reveals feebleness of the heart's action, but without any abnormal sounds. The primary cause of his trouble undoubtedly depends on a deficient innervation, causing a general feebleness of functional life; and the defective assimilation thus produced, is usually well adapted to the development of tubercular material, espe- cially at his age. The general indications of treatment in these early stages of the deposit and development of tubercular matter, are first to train the patient to regular muscular exercise, daily increased, and, as much as possible, out-doors in the open air; next, gen- erous diet--let him eat all the food he can assimilate. If there be evidence of imperfect oxygenation of the blood, give six or eight grains of the chlorate of potassa in some mucilaginous fluid, after each meal. I am fully satisfied that this salt pro- motes oxygenation, and, consequently, assimilation. The pres- ence of chlorine salts in the blood increases the capacity of that fluid for the absorption of oxygen from the air in the lungs. If in addition to this it be deemed advisable to produce an impres- sion on the nervous system itself, the hyoscyamus and Scutellaria will be found useful in allaying that nervous irritability which is almost universally manifested in a depressed condition of the system; while iron and nux vomica, or strychnia strongly in- crease nerve force and tone. The formula in general use in this hospital for such indications, is this:-- Rs Ext. Hyoscyamus,------------------------ 30 grs. Ext. Scutellaria,--------------------- 30 grs Ferri Sulphas,------------------------ 30 grs. Aloes Pulv.,--------------------------10 grs. Ext. Nux Vom.,------------------------ 10 grs. Mix, divide into 30 pills; take 1 before each meal. For the nux vomica, strychnia may be substituted in the proportion of one-thirtieth of a grain to each pill; but th'e extract of nux vomica is preferable, if it can be procured of a reliable character, on account of its more persistent and uni- form tonic action, while the alcaloid acts more directly as a stimulant to the spinal cord and medulla oblongata. Or the hydrastis canadensis, in the form of extract, and dose of one or two grains, may be substituted for the nux vomica, or be used in combination. In a proportion of these patients, and where tubercular deposit actually exists, substitute the cod liver oil for the pill, giving from a dessert to a table-spoonful three times a day. The oil may be emulsified by the addition of a half drachm or a drachm of the liquor potassae to the ounce of oil, and in this way may be taken by patients of squeamish stom- achs, or in cases of pyrosis or heartburn--producing an antacid effect, and should be taken from thirty to forty-five * minutes after eating. SERVICE--PROF. E. ANDREWS, M.D., SURGEON-IN-CHARGE. Radical Cure of Hydrocele.--The occasional failure of the irritating injection to set up a sufficient amount of adhesive inflammation to effect a cure in this disease, and the objection to making more incisions than are absolutely necessary, rendering the seton obnoxious, has led Dr. Andrews to devise a modification, embracing the advantages of both plans without the inconveniences from the failure of the one, or the double incision of the other. A. E. W. aetat. 23; admitted to hospital April 15th; hydro- cele of the left side, caused by a kick in the scrotum by his sleeping bedfellow, about six months previously. The tumor had attained only a moderate size, but, owing to the existence of a varicocelous condition of the left spermatic cord, it was deemed desirable to get rid of the increased weight of the distended scrotum. The operation, as performed, consisted of the introduction of the canula in the ordinary manner, and the injection of about half an ounce of tincture of iodine, care being taken that the canula was within the sac itself, and not opening into the cellular tissue--(a neglect of which point had caused the sloughing away of the entire scrotum in a case which had fallen under the operator's notice, in which the timid surgeon had injected his irritating fluid into the tissue, instead of into the sac.) After the injection, a piece of tape was pushed up through the canula, by means of a probe, into the sac, and an inch or two of it left within in an irregular, crumpled-up ball; the canula was now withdrawn over the de- pendent end of the tape, leaving this last hanging out of the orifice. After from thirty-six to forty-eight hours, a sufficient amount of inflammation is excited, and the third or fourth day the tape may be withdrawn, freely bathed in pus. By this means the amount of irritation can be pretty accu- rately graduated; and while it relieves the operation of the uncertainty of the simple injection, all the efficiency of the seton is obtained in a much neater and more workmanlike manner. Ununited Fracture of Humerus.--Thomas McCarty; aetat. 23; Irish; fell off a load of lumber Sept. 25th, 1866, fractur- ing the right humerus, about the junction of the middle and upper thirds. Admitted to hospital March 14th, 1867; entire want of union between the two fragments; no apparent excit- ing cause. Was operated on by perforation soon after his admission, and strict attention given to his general health; no degree of inflammation, however, was induced, nor has there been yet, although the operation has been thrice repeated, making four operations in all in the space of thirty days, each operation increasing in severity in the extent and thoroughness with which the tissues have been broken up. Fifth week, from admission, operated again by introducing, through a small incision, a common inch and a half wood-screw through the fragments in such a way as to secure perfect apposition and immobility, except a slight lateral motion allowed by the play of the screw. It is to be observed, that hitherto the operations have entirely failed in producing inflammation, and we .may now look for some, though it is to be confessed, not a complete union as the result of this procedure. April 22d, a sufficient degree of inflammatory action having been obtained, the screw was to-day withdrawn, and the arm dressed in the usual way. Andrews New Plastic Operation.--S. aetat. 21; in June, 1866, while carrying a coal-oil lamp broke the same, and, falling into the flames, was severely burned about the face; was admitted to hospital April 7th, 1867, with the loss of one eyebrow, ectropion of all the eyelids, quite extensive and much the worst of the left eye, and loss of both alae of the nose. April 10th, operated on the left eye by the curved method with revolving flaps, as described in the Examiner for 1866, page 465. It is proposed to attempt the restoration of the alae of the nose by the same method, and as the patient presents an unusually extensive field for the demonstration of the plastic operation, an effort will be made to furnish the readers of the Examiner with a full report of the various operations and their results.

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& (I i t o r i a 1. Chicago Medical Society--Annual Meeting.--The regular annual meeting of the Chicago Medical Society was held in the Court House,, on the evening of the 5th of April, 1867. The meeting was well attended, and the election of officers for the ensuing year, resulted as follows: President, Dr. J. P. Ross; Vice-President, Dr. John Reid ; Secretary, Dr. H. M. Lyman. Sanitary Committee.--Drs. N. S. Davis, R. G. Bogue, and R. M. Lackey. Censors.--Drs. E. L. Holmes, Thos. Bevan, John Reid. Committee on Ethics.--Drs. S. Wickersham, G. Paoli, T. D. Fitch. Delegates to the American Medical Association.--Drs. Macal- ister, Paoli, Wickersham, Reid, Blake, Bogue, Lackey, Fitch, and Fisher. Delegates to the Illinois State Medical Society.--Drs. Davis, Trimble, Fisher, Macalister, Bogue, Holmes, Lackey, Fitch, Hatch, Hildreth, Nelson, Loverin, Tucker, Reid, Blake, Quales, Fenn. A vote of thanks was unanimously tendered to the retiring officers for the faithful and prompt manner in which they had discharged their respective duties during the past year. After the transaction of some miscellaneous business, the society adjourned. Chicago Medical College Appointments.--During the past winter, Prof. F. Mahla, who had ably filled the two Chairs of Chemistry from the first organization of the College, tendered his resignation, in consequence of the pressure of other business. The places thus made vacant have been filled by the appoint- ment of-------Davies, Prof, of Chemistry and Physics in the Lawrence University, at Appleton, Wisconsin. Dr. Davies is an enthusiastic cultivator of the natural sciences, and will bring to his new position a high reputation, founded on several years' experience as a practical teacher. Daniel Nelson, M.D., who has given the course of instruction on Physiology and Histology, during the past lecture term, in a manner highly satisfactory to the Faculty and Students, has now been ap- pointed to the full Professorship in that department. Prof. H. A. Johnson, who felt compelled last year to resign the Chair of General Pathology and Public Hygiene, on account of ill-health, has again accepted a Professorship, to which has been assigned the full consideration of Diseases of the Chest. There is an excellent class of students in attendance on the Spring and Summer Course of Instruction, now in progress, and the College is steadily advancing in its career of usefulness and prosperity. Illinois State Medical Society.--The next Annual Meet- ing of the Illinois State Medical Society, will be held in the Hall of the House of Representatives, at Springfield, commenc- ing on the first Tuesday in June, at 10 o'clock, A. M. We are authorized, by the Committee of Arrangements, to state, that the Chicago, Alton, and St. Louis, and the Toledo, Wabash, and Great Western Railroads, will pass Members of the Society to and from the Meeting, over these roads, for one fare and one-fifth. It is also expected that the Illinois Central will do the same. N. S. DAVIS, Per. See. 111. State Med. Society. Chicago, April 15, 1867. We take pleasure in calling the attention of our readers to the following notices:-- To Physicians.--At the request of several members of the profession, Dr. Horatio R. Storer will deliver a private course of twelve lectures, upon the Treatment of the Surgical Diseases of Women, during the first fortnight of June, at his rooms in Boston. Gentlemen attending the course, will be required to show their diplomas. Fee $50. Hotel Pelham, Boston, March 29, 1867. Charitable Eye and Ear Clinic, No. 305 State, cor. Van Buren St.--Trustees: Hon. Lyman Trumbull, President. C. T. Bowen, Esq., Secretary and Treasurer. W. E. Doggett, Esq. C. H. Holden, Esq. Jos. G. Hildreth, M.D. Attending Surgeon. This institution is open daily, at 12 o'clock, for the treat- ment of the poor of the Northwest. Clinical instruction will be given during the lecture season. Indiana State Medical Society.--The next regular meet- ing of the Indiana State Medical Society will be held at Indi- anapolis, Ind., on Tuesday, May 21st, 1867. We hope all our readers in that State will remember the day, and see that their respective localities are well represented. Chicago Medical Journal.--This periodical has again changed hands. Drs. Holmes, Lyman, and Lackey have vacated the editorial chair, and given place to Dr. J. Adams Allen, Professor of Principles and Practice of Medicine in Rush Medical College. The retiring editors were men of tal- ent, industry, and integrity, and their sudden displacement will be regretted by many. Their successor is well known to the readers of that journal, he having occupied the same position in connection with the late Prof. Brainard, three or four years since. Money Receipts from Feb. 21st to Mar. 22d.--Drs. R. D. Cogswell, Nauvoo, Ill., $3, E. Robbins, Pontoosuc, Ill., 3, P. G. Kelsey, Fort Wayne, Ind., 5, W. L. Krieder, Prairie City, Ill, 3, Wm. Hoyne, Monmouth, Ill., 3, A. C. Corr, Carlinville, Ill., 3.00, G. Bradley, Waverly, Ill., 3, D. La Count, Chilton, Wis., 8, G. A. Bradwell, Prophetstown, Ill., 3, H. C. Lester, Newcomer, Ind., 3, S. D. Mercer, Omaha, Neb., 3, M. A. McClellan, Canton, Ill., 3, St. Joseph Medical Society, St. Joseph, Mo., 3, John Griffin, Newton, Ill., 3, M. S. Wilson, Griggsville, Ill., 3, J. II. Hollister, Chicago, Ill., 5, Herbert Harris, Wheeler, Ind., 3., E. V. Doles, Chicago, Ill., 3. Mortality Report for the Month of February:-- CAUSES OF DEATH. Accidents,______________________ 2 Abscess,________________________ 1 Bronchitis,____________________ 1 Cancer,_________________________ 2 Colds,__________________________ 6 Croup, _________________________ 8 Consumption,____________________40 Convulsions,____________________43 Childbed,_______________________ 4 Congestion of Brain,____________ 1 Congestion of Lungs,____________ 7 Delirium Tremens,--------------- 1 Drowned,________________________ 1 Decline,________________________ 1 Diphtheria,_____________________ 5 Dropsy, ________________________ 7 Disease of Brain,_______________ 1 Disease of Bowels,______________ 1 Disease of Heart,--------------- 4 Disease of Liver,_______________ 2 Disease of Lungs,_______________ 5 Disease of Hip,_________________ 1 Erysipelas,_____________________ 1 Fever, Congestive,______________ 6 Fever, Remittent,_______________ 3 Fever, Spotted,----------------- 1 Fever, Scarlet,_______________ 10 Fever, Typhoid,________________ 5 Fever, Childbed,--------------- 2 Fever, Typhus,________________ 1 Hydrocephalus,________________ 10 Inflammation of Bowels,________ 7 Inflammation of Brain,-------- 3 Inflammation of Lungs,_________11 Inflammation of Throat,-------- 1 Inflammation, not stated,------ 2 Killed, _______________________ 1 Marasmus,---------------------- 1 Measles,----------------------- 1 Old Age,_______________________ 9 Poisoning,_____________________ 1 Paralysis,_____________________ 3 Pneumonia,___________________ 2 Rheumatism,-------------------- 1 Suicide, _____________________ 1 Stillborn,--------------------- 8 Spasms,________________________ 4 Small Pox,_____________________ 3 Teething,_____________________ 12 Whooping-Cough,________________10 Ulcer__________________________ 1 Unknown,______________________ 15 Total,_____________________________________r____________ 280 Total number last year for the month of March,__________ 254 Increase,_______________________________________________ 26 DIVISIONS OF THE CITY. North,-----67 | South,_____90 | West,------123 | Total,______280 Total number during the month of March,_____________________ 280 Total number during the month of February,---------------- 255 Increase,_________________________________________________ 25 Ages of the Deceased.--Under 5 years, 143; over 5 and under 10 years, 16; over 10 and under 20, 16; over 20 and under 30, 29; over 30 and under 40,27; over 40 and under 50,17; over 50 and under 60, 7; over 60 and under 70, 9; over 70 and under 80, 10; over 80 and under 90, 2; over 100, 2; un- known, 2. Total, 280. NATIVITIES. Chicago,-----------151 Other States,_______48 Bohemian,----------- 1 Canada,______________ 4 England,------------- 2 France,_____________ 1 Germany,____________38 Holland,____________ 1 Ireland,____________25 Norway,------------- 3 Sweden,------------- 2 Scotland,----------- 3 Unknown,------------ 1 Total,-----------280 The attention of the members of the Massachusetts Medical Society is respectfully called to the following communications from the Boston Medical and Surgical Journal:-- Treatment of Acute Rheumatism. Messrs. Editors,--Having for a year past used what I consider a new remedy for rheuma- tism, and with better success than from any other remedy, I consider it proper to ask the profession to make a trial of it. It is the syrup of lime, made according to Trousseau's prescrip- tion, as found in Parrish's Pharmacy. I have used it, accord- ing to the severity of the case and the age of the patient, in the dose of ten (10) drops to forty-five (45) drops, and repeated in from two (2) to six (6) hours, as symptoms have seemed to demand. In but one (1) case has any opiate been required from the beginning. Two (2) cases were complicated with Bright's disease, as indicated by the great abundance of albu- men, and the casts, as seen in the urine. In one of these the albuminuria entirely dissappeared, and in the other it has been largely diminished. There has been no constipation, but generally looseness of the bowels, after a couple of days' treatment. The medicine is best taken in unskimmed milk, in quantity from a tablespoouful to four (4) ounces, according to the size of the dose of syrup. Hoping that other members of the profession may meet with the success which I think I have had, I am very truly yours, Boston, Eehruary PS3, 1867. Chas. E. Buckingham. For the information of our readers, we copy from Parrish's Pharmacy the prescription alluded to:-- "Calk Saccharatum, Syrupus Calcis. -- Trousseau used the following proportions for producing a solution of lime by the aid of sugar:--I part of slaked lime, 10 parts water, and 100 parts syrup are boiled together for a few minutes, strained and diluted with four times the weight of simple syrup. "This syrup has an alkaline taste and reaction, and is the solution of a chemical compound of sugar and lime. It is used for the same purposes as lime water, but on account of its caus- ticity it is necessary to dilute it considerably. It is given to children in the quantity of twenty or thirty grains during the day; adults take from two to three drachms during the same time." City and Country Population of England.--According to the Registrar-General, in 1861 the population of England living in the cities and large towns amounted to 10,930,841; of those living in the country and in small towns, 9,134,386.

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book iiDttrtsi Obstetrics; the Science and the Art. By Charles D. Meigs, M.D., lately Professor of Midwifery and Diseases of Women and Children, in Jefferson Medical College, of Philadelphia, etc., etc., etc. Fifth edition, revised, with one hundred and thirty illustrations. Philadelphia: Henry C. Lea. 1867. This is a new and carefully revised edition of Dr. Meigs' well- known work on Midwifery. It is published in excellent style, with substantial binding, and contains 760 pages. The author has long been one of the ablest teachers and writers in our pro- fession. And it is only necessary to remind our readers, that the work before us is everywhere recognized as a standard authority. For sale by W. B. Keen & Co., 148 Lake St.

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Code of Medical Ethics, adopted by the American Medical As- sociation. New York: Wm. Wood & Co. 1867. The publishers have furnished the profession with the Code of Ethics in the form of a small duodecimo volume, neatly printed and bound. A copy of it should be purchased and care- fully read by every practising physician and surgeon in the United States. For sale by Wm. Wood & Co., 61 Walker St., New York City.

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$11t c 11 a n a. BLOODLETTING THEN AND NOW. By. C. H. SPILLMAN, M.D., of Harrodsburg, Kentucky. Fully persuaded that a proper conception of the modus operandi of bloodletting as a therapeutic agent, is an important desideratum in our profession, I propose to throw together, in as small a compass as may be, the results of inductions drawn from observation and experience, with special reference to this subject, running through a period of 35 years. Believing, as I sincerely do, that the prevailing doctrines on this subject are unphilosophical, and lead to disastrous practical results, I read, with much pleasure, Dr. Wilson's "Plea for the Lancet," in vol. XV., No. 24, of the "Reporter," as indicating a disposition on the part of the profession, to a more thorough examination of the subject, which, I doubt not, will lead to more rational views. When I first came upon the arena in 1832, I was not long in becoming convinced that the lancet was used too indiscrimin- ately, and .sometimes to an injurious extent. I did not bleed as much as my neighbors, because I met with a-number of cases that I could as easily and more safely control without than wjth it. In many others, however, it was a sine qua non to success. IIow stands the matter now? Although diseases are the same, climate the same, morbific agencies the same; although organic structure is the same, vital susceptibilities the same, in- volving the same therapeutical relationships, pointing to the same indications of cure; yet such has been the revolution in the medical mind, that, at the present time, a large proportion of living practitioners rarely employ bloodletting as a remedial agent, and quite a number discard it altogether. Many of our late writers on therapeutics, if they justify its occasional em- ployment, authorize it in such dubious phrase, with such ad- monitory qualifications and restrictions, as to clothe it in the garb of suspicion, and deter the junior members of the profes- sion from its employment, even where indispensably called for. I am not unaware of the fact, that the task before me is an ungracious one. It would have been more consonant to my feelings, could I have endorsed sentiments consecrated by so many justly distinguished advocates. To the popular doctrines on this subject, however, I find myself in a position of inexor- able antagonism, by the logic of facts and figures which are impregnable. That more liberal enlightened views are de- manded, and will ultimately obtain. I have an abiding convic- tion; and, whenever medical men shall have divested themselves of the leaven of empiricism, to which that distrust in regard to bloodletting as a remedial agent, which now sways the popular mind, may be legitimately traced, and come to view this subject in the light of rational physiological principles; we shall then have a fuller appreciation of that powerful remedy, which, as Dr. Wilson justly remarks, nature claims as her own, and shall have made an important step, toward the highest attainable perfectibility of our art. From one opinion, however, advanced by Dr. W., in his excellent paper, I must take the liberty of dissenting. That this prejudice originated with the non-medical public, I think, is exceedingly questionable; and if the doctor will submit the matter to a thoughtful review, he will find the responsibility where least excusable, with those who ought to know better. My observation is, that the popular verdict stands opposed to medical inefficiency in that regard. Disguise it as you may, I apprehend it is accepted as a concession to the various shades of empiricism which flood our land, all of which have been weighed in the balances and found wanting. There is no therapeutical agent, however valuable and indis- pensable to a successful exercise of our art, that may not be brought into disrepute by injudicious use; and a misapprehen- sion which underlies the general prejudice which has obtained in regard to the lancet, relates to the principle on which it operates in the subversion of morbid action. Had it not been regarded as a physical agent, operating on mechanical prin- ciples, it would never have been confided to the hands of the ignorant, and we should have had fewer failures and miscar- riages, which have contributed largely to this prejudice; for it is with this as it is with all other remedial agencies, the more powerful for good, the more prolific of evil, if misapplied. Employed as a vital agent, regardless of quantity, pushed to a given effect, by a practiced hand, under the guidance of a culti- vated intellect, it is not only perfectly safe, but unquestionably the most potent remedial agent known to our art; nor can it be dispensed with; without surrendering to a weak vascillating tim- idity, compromising the most sacred obligations that can attach to a medical man, and greatly circumscribing the usefulness and efficiency of the medical art. The argument against the lancet, founded upon its supposed debilitating effects, is an abstraction, and not an induction from a careful observation of facts. On the contrary, every practitioner who has had an extensive experience in its employ- ment, and witnessed its magical effect in the instantaneous subversion of the most violent forms of morbid action, appreci- ate it as a means of economising strength. In a sudden attack of either a congestive or inflammatory character, although the patient may have a feeling of great prostration, and is unable to put forth his strength, he is not weak. Take off the weight by which he is overborne for the time, and he is still strong. "The giant," says an able writer, "that lies prostrate on the earth, mastered by superior power, has still a giant's strength, though he do not at that moment put it forth. Give him but the chance to throw off the load that keeps him down, and he will soon show you that he is not weak." This is a very apt illustration of depressed vital action, mis- named debility, under the weight of disease. The intelligent physician will not be misled by the illusion. lie will at once recognize this apparent debility, as the sympathetic influence of a dangerous leison in some vital part. Although greatly diver- sified in the phenomena they present, according to the peculi- arity of the tissues involved, and the manifold remote causes which give rise to them, I apprehend there are few maladies not characterized by inflammation or venous congestion, either of which, by sympathetic influences, may occasion great prostra- tion. They may be sudden in their onset, or insidious and gradual in their approach. They may persist for some time in a simple state of functional disturbance, but ofttimes run rapidly into irremediable structural alteration. In the latter case, relief, if attainable, must be prompt and instantaneous. The practitioner, seeing the peril, and comprehending the situ- ation, will find little room for temporizing. The most powerful means of equalizing the circulation and taking off the oppres- sion, are called into requisition; and a philosophical view of the medium through which, and the manner in which, both morbific and remedial agents operate upon the vital economy, will at once suggest bloodletting as the most appropriate, because the most prompt and decisive means of accomplishing the object. Irreconcilable as this may seem with that hypothesis, founded upon the mechanical philosophy, which assumes bloodletting to be a debilitant; it is nevertheless in strict accordance with the known therapeutical effect of that agent corroborated by the observation and experience of every one who has employed it, under an intelligent recognition of the principle on which it operates, in the submersion of morbid action. The whole gist of the opposition to bloodletting, is predicated in conformity with the hypothesis, that it is necessarily debili- tating; and this arises from a misconception of its modus operandi as a remedial agent. Although a low pulse speedily raised, a shrivelled surface filled out, cold extremities warmed up, equilibrium of circulation reinstated, lost strength restored, vital energy renovated, are phenomenas which have been a thousand times observed to follow immediately on the intelligent employment of the lancet; and in multiplied instances such phenomena could have been elicited by no other means; it is nevertheless abandoned, on the ground of its alleged incompatibility with the assumed hypothesis. Admitting the loss of blood to be intrinsically debilitating in a normal state of the system, and allowing our inability to re- concile this fact with its powerfully restorative effect in many forms of disease, the truth of which cannot be successfully con- troverted, it is no more seemingly paradoxical than many well- known facts with which the history of medicine abounds; and affords a striking exemplification of the practical value of the principle inculcated in Hoffman's Aphorism--Ars medica tota observationibus. Quinia, in its nature and properties, is no less marked, intrinsically, as an excitant, than is the lancet a debilitant; and I apprehend the objector will find about as much difficulty in accounting, on philosophical principles, for the powerfully sedative influence of the former in controlling fever, as he will in reconciling the restorative influence of the latter, in diseases of depression, with its assumed debilitating effects. To assume an hypothesis on sufficient data, and then reject every principle not in harmony with it, is unphilosophical. It is a humiliating fact, that in the present imperfect state of our knowledge, much of our reasoning, inconclusive, and un- satisfactory, rises no higher than mere speculation. However gratifying the reflection that by a close observance and careful analysis of facts, much is known in regard to the therapeutical effects of many remedial agents, still there are doubtless a great variety of hidden, unobserved influencing circumstances, connected with pathology, and therapeutics, which, if known, would greatly modify our inductions. From a carefully noted and patiently classified series of facts, running through a long period, during which, in disregard of the popular prejudice, I have employed the lancet, not only to subdue violent inflammation, but to take off the oppression, and restore the strength, in cases of the most profound congestion, I am prepared to bear testimony to its magic power as a thera- peutic agent; and hesitate not to say, after a patient, persever- ing trial of all its reputed substitutes, that many such cases can be reached by no other means known to the profession. The number of lives sacrificed to this prejudice against the lancet, compared with those who fall a victim to its use, I doubt not, is as a thousand to one. Look at the fearful increase of chronic diseases since the lancet has been partially ignored, and the profession has become tender-footed on the subject of bloodletting. Or to furnish a still more striking illustration; go to those districts where em- piricism in its various forms, having manufactured, now subsists upon this prejudice, and lay it to the line and plummet of rigid vital statistics, and you will find multitudes of invalids who ought to have been restored to soundness by a prompt energetic treatment, whose cure, in consequence of an inefficient, tempor- izing course, has been incomplete; vestiges of disease still re- main ; vital leison still lingers, ultimately to develope itself in some chronic form; and the tenure on life simply prolonged a brief period. It is probable that tubercular disease in its diversified forms,, is more destructive to human life than all other maladies com- bined. The best lights reflected from pathological anatomy, note it as a product of inflammation. A patient investigation of the etiological history of very many of these diseases, rarely fails to reach an inflammation as the point of inception. This fact is suggestive, and its inculcations should not be disregarded. It strikingly illustrates the folly of temporizing in all grave maladies; and affords the highest presumptive evidence against the expectant plan of treatment, which reposes upon the medical powers of nature, while disease, none the less destruc- tive, from its insidious character, is stealthily settling down upon the vitals. The point is this, that tubercular disease in its multiplied forms and various complications, is, in large measure, the sequel to an inflammatory attack, which might and ought to be relieved by depletory measures so decisive, as to render the cure complete; and its great prevalence and fatality may be attributable to the existing popular prejudice against the only efficient means of subduing it in its incipiency.-- Medical and Surgical Reporter.

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PHYSIOLOGICAL AND THERAPEUTICAL ACTION OF COD-LIVER OIL. By A. BISSELL, M.D., of New York. The discussion of the therapeutical applications of cod-liver oil, started by Dr. Joseph Adolphus, of Hastings, Mich., in his able communication in the Reporter of December 8th, 1866, has led me to offer the following remarks on the subject for your columns. M. Bouchardat, Professor of Hygiene at the Academy of Medicine, Paris, says: "The minute division of the iodine in cod-liver oil, the par- ticular state in which it exists, must singularly facilitate its absorption by the tissues, and Can in this way contribute more than the absolute proportion of this substance to the marked effects which this oil exerts on the animal economy. "Also, iodine in the oil is not eliminated from the system, as the other soluble preparations of iodine : in this elemen- tary combination its action is slower, more regular, and more persistent, as it is successively set at liberty in the economy, in proportion as cod-liver oil is gradually decomposed in the blood."--[Manuel de Materie Medicale, page 71^9.--18567\ The action of cod-liver oil on the system is a double one; it is nourishing by its fatty elements, and curative by its medicinal bodies--iodine, bromine, and phosphorus, which it naturally contains; and to these three substances must be attributed its superiority over other fats or oils, eithei- animal or vegetable, in the cure of diseases. These facts, discovered and proven by physiologists in their experiments on animals, and confirmed by the experience of physicians in their daily practice, have been corroborated during the last eight years, in a most illustrative manner, by the administration, to a large number of patients, of cod-liver oil five times richer in iodine, bromine, and phospho- rus than any of the cod-liver oils known before. Cod-liver oil, as well as other fatty substances, w'hen taken in too large quantities, is apt to disturb the stomach and derange the functions of the intestinal canal. Only a small quantity can be digested and assimilated, the rest passing oft unchanged, producing more or less frequent and abundant alvine evacuations, in which are contained the superfluous oils or fats. Observations prove that the gastric juice has no action whatever on fats or oils, the pancreatic juice being the only body, which, by its emulsive properties, causes the absorption of these substances into the economy; and, therefore, all the oil not emulsioned by the pancreatic juice is evacuated by the intestines just as it was taken. The knowledge of this impor- tant fact is due to the recent observations of Claude Bernard, a well known authority in physiology. The oil once emulsioned by the action of the pancreatic juice, is brought into the general current of the circulation as follows: it is first taken up by the chyliferous vessels on the surface of the small intestines, and passing through the mesenteric glands and the thoracic duct, it is discharged in the left subclavian vein, where it mingles with the venous blood returning to the right cavities of the heart. This blood, and the fresh nutritious elements, furnished by the two subclavian veins, are pressed into the lungs to be there oxidized and altered; while passing through the pulmonary circulation, the oily molecules a*re modified and almost all of them destroyed. The blood, then ready anew for nutrition, passes into the left ventricle, to be thence distributed through the arterial system, carrying along with it, some oily globules left undecomposed during their speedy passage through the lungs, said oily globules to be successively altered in the circu- lating blood. The medicinal oil, evidently brought undecomposed into the lungs, and partly in the general current of the circulation, is modified, losing not only its emulsive form, but also its oleagi- nous characteristics, so as to constitute a part of the arterial blood. Iodine, bromine, and phosphorus, are then set free during the process of nutrition of the tissues, each part of our system appropriating to itself the substance it needs. The tissues, in contact with the nutritious blood, having a tendency to appropriate to themselves the elements most proper to maintain their healthy condition or to alter it, when un- healthy, is-it not judicious to conclude that the lungs first and then the rest of the system, when affected with bronchitis, phthisis, scrofula, under any variety, or rickets, etc., etc., are highly benefited by the healing and restorative action of the oil and its medicinal constituents, minutely, naturally, and per- sistently brought into contact with the diseased parts ? That oils and fats are successively carried through the economy, and transformed, as above described, is amply de- monstrated by the experiments of the most eminent modern physiologists, such as Claude Bernard, Tiedemann and Gmelin, Leuret and Lassaigne, Sandras, Bouchardat, Blondlot, Delafond, Gruby L. Corvisart, J. C. Dalton, jr., A. Flint, R. Dunglison, etc. We must not forget this important point, that oils or fats go into the blood undecomposed and unchanged, being merely infinitesimally divided by the pancreatic juice; but if an oil contains substances, in a close chemical combination, so that they cannot be easily separated, these substances will of course be carried into the blood with the oil itself. This is just the case with a cod-liver oil which contains a large proportion of iodine, bromine, and phosphorus. Iodine and bromine have so strong an affinity for oil, that they cannot be separated from it by chemical reagents, not even by strong sulphuric acid. They must, therefore, be carried with the blood and liberated when the oil is transformed, in the process of nutrition, into its elements, and becomes the chief agent by which the heat of the body is maintained. Knowing, then, that to the nutritive property of the oil is superadded the alterative, and stimulating power of a comparatively large quantity of iodine, bromine, and phosphorus, who can doubt the efficacy, as a medicine, of cod- liver oil, if made richer with these substances ? Phosphorus, a part of our brain and bones, is a powerful diffusible stimulant, exciting the nervous organs, heightening the muscular power and mental activity, and relieving the despondency of mind occasioned by many serious diseases. Iodine and bromine are superior to all alteratives for improv- ing and purifying the depraved nature of the blood. They are the best remedies we possess for checking and controlling the swelling and induration of the glandular system, the ulcerative process in scrofulous complaints, the diseases of the lungs, etc. Obviously, the main point, in such serious affections, is to check and control at once the ulcerative process, and to do so it is of the greatest importance to use prompt and active medication. SUPERIORITY OF IODINIZED COD-LIVER OIL OVER SIMPLE COD-LIVER OIL. Until of late, natural and pure cod-liver oil has been the best remedy, and the one most generally used, with more or less success, in diseases of the lungs when of a tuberculous charac- ter. The period of the malady when the oil was first employed, and also the purity and strength of the remedy accounting for the success or failure. Pure cod-liver oil is more likely to cure consumption, scrof- ula, rickets, swelling of the glands, etc., in the first stage of the disease; in the second and third stages it mitigates the severity of the symptoms and prolongs the life of the patient, but seldom saves it. The reason for this difference of action is simply that the pure oil contains iodine, bromine, and phosphorus only in minute quantities, which although sufficient to cure a disease in the beginning, is not powerful enough when it assumes a graver type. If we suppose for an instant the discovery of a new natural cod-liver oil, containing more iodine, bromine, and phosphorus than the oil in present use, there is not the least doubt but that every physician would prescribe it in preference, fully confident of its enhanced qualities. The natural consequence of this proposition explains satisfactorily why the medical profession should give the preference to iodinized cod-liver oil, which con- tains a larger proportion of iodine, bromine, and phosphorus than the oil in present use; these active elements, as before remarked, are in such a peculiar combination that their action is slow, regular, and persistent, being successively set at liberty in the economy in proportion as the oil is decomposed in the process of animal life. Some physicians are so well convinced that the curative properties of the oil reside in these three substances, that to obtain a full effect they prescribe very large doses of the oil, sometimes giving two, three, and even four tablespoonfuls three or four times a day, the larger quantity amounting to no less than half a pint daily. That their object is not attained is fully proven by physiologists, who have demonstrated that only the small quantity of oil emulsionized by the pancreatic juice is digested and carried into the blood, the rest being passed off nearly as taken. In view of the above physiological and chemical facts, experi- ments were made in 1858, which, after many trials, succeeded in preparing a compound idinized cod-liver oil, which is simply the best Newfoundland cod-liver oil combined with four times as much of iodine, bromine, and phosphorus as that naturally contains. Pure cod-liver oil varies considerably in composition, as may be seen by comparing the different analyses published in works of chemistry and materia medica. A quart contains 1 to 4 grains of iodine; | to f of a grain of bromine; | to | of a grain of phosphorus. In I860, there was published in the Repertoire de Pharmacie, edited by Professor Bouchardat, at Paris, the formula of a cod-liver oil, which contains per quart in addition to the above quantities Iodine,--------------------------------16 grains. Bromine,------------------------------- 2 grains. Phosphorus----------------------------- 2 grains. The combination is made so that the oder, taste, and color of the natural oil are preserved. This preparation being consequently five times more active than the richest commercial cod-liver oil, will tend to restore health by its curative action thus enhanced, in a much shorter time than the simple kind, and attain the desired effect where the other will fail. The dose of this oil is only a tablespoonful for adults, and a dessert or a teaspoonful for children, according to age, three times daily. It may be administered at any hour, but it is preferable to select the time of meals, since we know that the pancreatic secretion manifests itself only during the stomachal digestion, to act immediately on the alimentary principles as soon as they pass from the stomach into the intestines. Though the quantity of iodine is very small in each dose, it acts never- theless wTith a greater efficacy than a larger quantity of any of the iodides, for the reason stated by Professor Bouchardat and others, that iodine in cod-liver oil is not eliminated from the system as the other soluable preparations of iodine, but is successively deposited in the economy as the oil is gradually decomposed in the blood. When iron is required with the oil, the dragees or syrup of pyrophosphate of iron will be found the most agreeable and active adjuvant. It is best for children and delicate persons to take the syrup of iron after the oil."--[Medical and Surgical Re- porter.

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The Indigestions; or Diseases of the Digestive Organs Func- tionally Treated. By Thomas King Chambers, Honorary Physician to H. R. H. the Prince of Wales, Consulting Phy- sician and Lecturer on the Practice of Medicine at St. Mary's Hospital, Consulting Physician to the Lock Hospital, Author of "Lectures Chiefly Clinical," etc. Philadelphia: Henry C. Lea. 1867. Chicago: S. C. Griggs & Co. One vol- ume, octavo, pp. 287. This work has grown out of a volume by the same author, published in 1856,* in which it was essayed to give both the physiology and pathology of digestion, or rather, an anatomi- cal view of this function in health and disease. The subject- matter of the present volume consists principally of two hun- dred and twenty-seven cases, classified according to the various forms and results of Indigestion, which they specially illustrate; forming, to use the author's figure, a sort of skeleton, articu- lated together by argument, and made muscularly active by practical observations. * " Digestion and its Derangements." By Thos. K. Chambers. The greater portion of this work is evidently written currente calamo, and reads very much as the verbatim report of a clini- cal lecture would--a lecture, however, by one of matured judg- ment, intimate knowledge of his subject, and abundant expe- rience. While it thus loses somewhat in style, it certainly gains in a freshness of expression, and an individuality which make its perusal a positive relief, after wading through some of the more ambitious monographs, in which a polished syntax sets forth a scant array of thought and argument, and rhetorical flourishes do duty for facts and illustrations. Laying down, in a few weighty sentences, (pp. 17, 18,) a broad ground work of accented premises, embracing the nhvsi- ology of digestion, its vital importance, and its more or less in- timate connection with every other function of the human body, Professor Chambers announces the following propositions, which underlie all his teachings of medical theory:-- * * * * all disease is, for the physician, essentially a de- ficiency of life, an absence of some fraction of the individual organization of force. * * * * the organic laws of health and disease are one, * * the essence of the latter is a deficiency of the vital action which characterizes the former, * * all successful medical treat- ment is a renewal of that vital action. Through the subsequent half-dozen pages of this first section of the introductory chapter, he insists on the paramount impor- tance of assiduous attention to the digestive viscera in every stage of disease; and discusses the peculiarities arising from the oneness of the digestive organs and the relatively greater importance of preserving their integrity, as compared with that of the dual organs, such as the lungs, kidneys, etc. Section II of this chapter is taken up with explanations of the terms and divisions used in his elucidation of the subject. Chapter II. treats of the indigestion of various food, starchy and saccharine, or vegetable--albumenoid--fatty--and watery --with a section of treatment based on the articles of food not digested, and one of treatment based on the general pathologi- cal condition. This chapter embraces some valuable hints on dietetics, in the course of which is given the following:-- T ,77/7/7dv 717z>/>>/_ -fnv J'n.'n/il'irla 1. Whey. 2. Milk and Lime-Water. 3. Plain Milk. 1. Beef Tea. 5. Mutton Broth. 6. Sweetbread. 7. Boiled Partridge. 8. Chicken. 9. Mutton Chop. 10. Roast Leg of Mutton. This chapter is illustrated by details of torty-nme cases, which have all the vraisemblance of clinical studies, and the mode of making which, by the way, deserves transcription:-- I make it a rule, to which exceptions need be very few, to write all prescriptions and papers of advice in a copying-book, which makes a duplicate of them by means of transfer-paper; and at the back of this transcript I write, usually with the patient before me, his symptoms and history at least as far as to explain my reasons for the advice, before I go on to the next page. Habits of social life leading to indigestion form the subject of the next chapter, and include eating too little--too much-- sedentary habits---tight lacing--sexual excesses--compression of the epigastrium by shoemakers--solitude--intellectual ex- ertion--want of employment--abuse of purgatives--of alcohol --tobacco--tea--opium. Abnormal Pains (chap. IV), Vomiting (chap. V), Flatulence (chap. VI), are equally full in illustration and treatment; while the chapter on Diarrhoea is a model of analytical brevity. The following chapter treats of Constipation and Costiveness, and chapter IX of the varied and often obscure diseases of the nervous system arising from indigestion. One or two samples of the style in which our author gives his views and we must conclude:-- * The chief office of the mucous membrane is not to secrete mucus. It is most active when it is not doing so, and its ac- tivity is decreased just in proportion to the copiousness of the mucus. Typical health certainly consists in its absence; ro- bust people pass weeks without expectorating; many find their handkerchiefs clean and unfolded after several days in their pockets, spite of all the voluntary and involuntary irritants to which the Schneiderian membrane is subject; and the urinary and intestinal outlets ordinarily contribute only an infini- tesimal quantity, which may be attributed to a temporary defect in some fraction of their large area. The real office of mucous membrane is to offer a passage inwards for oxygen, water, fat, albumen, and other useful substances, and to defend the less easily renewed tissues be- neath it from the deleterious action of external agents. These functions it best fulfils when it is bedewed with a moderate ex- halation, and not with mucus. Chap. II.--Indigestion of Starch and Sugar. It is truly by aid of the digestive visera above, that con- sumption can be curable. Medicines addressed to other parts may be indirectly useful sometimes, but they more commonly impede the recovery; whereas aid, judiciously given in this quarter is always beneficial and often successful. The chest is the battle-field of past conflict; the lymphatic duct the drill-ground for new levies of life. As easily assimilated oil comes, in fact, into the short list of directly life-giving articles in the pharmacopoeia; for it is itself the material by which life is manifested. Hence, under its use, beneficial influences are exerted throughout the whole body; old wounds and sores heal up; the harsh, wrinkled skin regains the beauty of youth; debilitating discharges cease, at the same time that the normal secretions are more copious; that the mucous membranes become clear and moist, and are no longer loaded with sticky epithelium; the pulse, too, becomes firmer and slower--that is to say, more powerful, for abnormal quick- ness here is always a proof of deficient vitality. Such are the effects, perfectly consistent with physiology, of supplying a suf- ficiency of molecular base for interstitial growth. To find the easiest assimilated oil, and to prepare the diges- tion for the absorption of oil, are the main problems in the cure of consumption. (Chap. II--Indigestion of Fat, pp. 58-9.)

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(c) o r x t PS p o u a t n r e Mount Vernon, Ill., March PS6, 1867. Prof. N. S. Davis:-- Dear Sir,--The probable return of cholera to this country during the present year makes it necessary that physicians should devote some time and thought to devising a better mode of treatment than has been adopted heretofore. This better mode of treatment must be based upon changed or rather settled views of the pathology of cholera. Without troubling you with a lengthy exposition of my views, let me tell you in a few words what they are. I have held them for a number of years, communicating them freely to my neighboring physicians, but have had few opportunities of putting them to the test. They are these: The fatality of cholera is due to the dessication of mucous lining of the bron- chial tubes and pulmonary vessicles, whereby the proper oxygen- ation and decarbonization of the blood are prevented. That these conditions actually exist would not be controverted by any one, but the why has not yet been fully ascertained. Dr. John- son comes more nearly to an explanation, when he attributes it to paralysis of the capillaries of the lungs. Does not the theory of dessication more fully account for it? Fluids do not readily permeate dried membranes--in cholera this condition actually exists--that is, the blood of a cholera patent, from some cause, does not receive the full benefit of due and proper oxygenation. Now, if it were fully ascertained by post mortem examinations that the assumed condition of the pulmonary mucus linings does actually exist, would it not be admitted that the hindrance to the process of osmosis would be sufficient to ac- count for the phenomena of cholera? Farther, although the investigations of pathologists have not positively shown this condition to exist, (perhaps from their attention not having been directed to it) do not some of the ascertained facts give con- siderable plausability to this theory? The upper air-passages are always dried, as evidenced by the dry hissing voice and by the actual condition of the nostril and mouth, as seen in life; and may we not assume that the same condition extends to the pulmonary vesicles. Is not this condition of the same parts still further proven, or at least rendered probable, by the fact that, while there is no mechanical hindrance to the free entrance of air into, and its diffusion over, the interior surface of the pul- monary linings, it comes from the lung almost unchanged by expiration, having'lost but little oxygen and gained but little carbonic acid gas. See Davy & Bamel. What so readily accounts for this unchanged condition of inspired air, as that the pulmonary linings are dessicated (by the unknown cause of cholera) to such an extent that the function of osmosis cannot be fully and properly performed. Now, theories are of but little avail if they do not point out a mode of treatment. But does not this theory point clearly to a rational mode of treatment? It seems to me that the inhal- ation of moist vapor, medicated as each practitioner might prefer, would be a necessary and rational mode of treatment. Would not, again, the exclusion of larger doses of opium from our prescriptions follow as a necessary consequence, for, if I am not mistaken, it is an ascertained fact that the pulmonary linings are found in a dried condition in cases of poisoning by that article. Would not this theory suggest the free use of such remedies at possess the property of oxygenating the blood when intro- duced therein through the stomach? Concentric friction of the extremities, as part of "Marshall Hall's Ready Method," would certainly suggest itself to the mind of every thinking physician as an important adjuvant. Would not, again, inhal- ation of vapor charged with iodine and other agents known to be destructive to vegetable life, immediately suggest itself to those gentlemen who have adopted the "Fungus Theory" of cholera? These random thoughts I have hurriedly thrown together, and hope that you will give them some thought and consider- ation, and should you think proper, submit them to your Medi- cal Society at its next meeting; and although they may be productive of no immediate good, they w'ill certainly afford food for thought, and possibly be productive of ultimate good results. I need offer you no apology for thus intruding these thoughts upon you without a personal acquaintance with you, for your known interest in, and devotion to, science is a sufficient warrant to me for so doing. Respectfully, etc., W. DUFF GREEN, M.D.

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Injuries of the Spine; with an Analysis of nearly four hundred cases. By John Ashhurst, Jr., A.M., M.D., Fellow of Col- lege of Physicians of Philadelphia, etc., etc., etc. Philadel- phia: J. B. Lippincott & Co. 1867. pp. 127. This is a well written and very valuable essay on a very im- portant subject. We fully commend it to our readers as worthy of a careful perusal. For sale by S. C. Griggs & Co., 148 Lake St.

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THE CHICAGO MEDICAL EXAMINER. N. S. DAVIS, M.D., Editor. VOL. VIII. MAY, 186 7. NO. 5. Gnmai (f otributuins ARTICLE XX. THE ACTION OF ALCOHOL UPON THE HUMAN SYSTEM. By R. L. WALSTON, M.D., Paris, Ill. Bead before the Esculapian Society. A few weeks ago, I observed that the National Medical Asso- ciation made the announcement that, for three successive years, committees had been appointed to make a report upon the action of alcohol upon the human system, but that no report had ever been offered--that each appointment had proved a failure. In all our medical literature, there is a complete dearth upon the subject; there is but one monograph in our language that has even a bearing upon this topic. It is for these reasons that I now bring my feeble offering and lay it as a willing sacrifice upon the altar of our profession; not that I entertained for a moment the vain aspiration that I should be able to supply the desideratum, but that I might incite others to do so. It is a subject surrounded by difficulties of which I at first had no conception, and to have prepared a labored, elaborate address upon this subject would have required much thought, great research, and some sparklings of genius. Time for thought I have not had, research I have never made, and to genius I lay no claims. But should I succeed in throwing a single ray of light across your path, or inspiring a single emo- tion within your bosoms, to impel you forward in the investiga- tion of this subject, my object is gained. By alcohol, is meant the intoxicating principle of all spiritu- ous or fermented liquors. It is an unnatural product, not found free in nature, but is always prepared at the cost of the destruc- tion or decomposition of other substances. It has had an exist- ence almost ever since the world was. We are informed in the Book that, away down in the dim twilight of the world's history, one Noah was drunken with wine, and, true to the instincts of such condition, he steeped his ingrate soul in that most unnat- ural crime. You may sweep back through channels of history into the dark aisles of tradition until superstition and ignorance become an impenetrable veil, illumined only by a few flashings from the Jewish theocracy or gleams from the Trojan fable, and you will find that this mysterious spirit has ever dwelt among the destinies of mankind, at one time sitting, like the hellish imps of discord, gibbering upon the hearthstone, and at another, like the angel of mercy, at the bed of the dying. From its multiple phases, moralists have been wont to represent it as Proteus, or the Old Man of the Sea; but if such figure be admissible, it is dependent upon the shape he assumes, whether he is the Goddess Hygea or the Juggernaut of destruction. The history of nations gives evidence in behalf of these state- ments. Greece rolled the car of ambition to the very acme of anticipated greatness and glory, and beheld, with complacent smile, her mighty achievements and unequaled strength; but when she pressed to her lips the intoxicating goblet, her brain ran wild, and she, like an avalanche loosed from some Alpine peak, plunged into the yawning chasm below. Her glory has departed, and, from her mournful ruins, from her desolated rubbish, there comes forth a .voice so potent as not to be mista- ken. Alexander, the world conqueror, surrendered to the wine- cup, and died as the fool dieth; his generals divided the known world between them and deluged it with blood. War is the great work, or rather the sport and triumph of death--the ter- rible generalissimo of evil, and his aide-de-camp is wine. But never, in the world's history, did intemperance reach its climax of sin and violence, of shameless crime and misery, never did it spread over the earth so like an epidemic, until our new, fair, fresh continent yielded the product of its rustling cornfields to the distillery. The vigorous and virgin soil yielded profuse harvests of grain, and the enterprising Yankee manufactured that bounty, which heaven had given for food for man and beast, into alcohol. And thus we had a surfeit of this precious remedy, and hence its shameful and unfortunate abuses. We may imagine the wealthy old Dutchman, sitting under his am- ple porch, from which the sun's rays were all excluded by his teeming fruit trees, gazing out over his luxuriant fields of wheat, of rye, of corn, and of clover; his cattle slumber in his rich pastures, and his sheep whiten the hillsides. He solilo- quizes :--" Oh, that I could find a market for my rural wealth! My barns are already filled, what shall become of my abundant stores?" His Satanic majesty is always accommodating to the rich, and he inspires a foreign schoolmaster to come to his aid; and thus the devil and the Scotchman made the wine-presses to run and gush like rills and fountains with this poisonous bev- erage, which heaven had appointed as a blessed remedy to quicken the sluggish pulse, sustain the failing nerves, and un- wrinkle the gathering brow of care. It is a well known but mysterious fact, that certain agents, when taken into the system, have, first, an elective, local action --that they manifest an affinity, a special preference in favor of some organ or parts of an organ; for example, subnitrate bismuth acts directly and locally on the extremities of the sen- tient nerves of the stomach, veratrum on the heart, and bella- donna manifests its preference in favor of the pupil of the eye? and alcohol is plainly shown to have an elective affinity in favor of the brain and nervous system. Why and wherefore this mysterious action, none may know. It is as mysterious as lan- guage, and all attempts to explain it is like the teachings of calculus, that zero above zero is the origin of quantity; it but makes darkness visible, and belongs, properly, to the ken of a future state. The physical change wrought in a simple piece of animal tis- sue by the direct action of alcohol is that of corrugation, which change is due to the difference in the affinity which the tissues have for alcohol and water. The change takes place by endos- mosis and exosmosis, the water passing out and the alcohol passing in in about two-thirds the quantity of water before con- tained; hence the corrugation or shrinking. The reason that the tissue absorbs less alcohol than it, in its normal state, con- tained water, is due to the coagulation of its albumen. This physical change makes an important alteration in the chemical relation of the different elements of the tissues, and since a cer- tain definite proportion must exist between the constituents before nutrition can possibly take place, you see at once how alcohol in the tissues of the animal body must derange all the nutritive functions. The change in the albumen does not take place in the vitalized tissues only in the most extraordinary alcoholic potations; but that such changes do take place, in rare instances, none can doubt. No considerable physical change can take place without seriously deranging the vital function of the changed organ or organs. Thus it is, that dogs are killed by the injection of the smallest amount of alcohol into the veins by the clotting of the albumen. Albumen is not, in its own state, organizable, but is changed to fibrine and then to organized tissue, and anything that destroys or prevents the change, of albumen to fibrine necessarily intercepts nutrition and cuts off all repair of tissue, and causes starvation and death of nerve-tissue, for we shall show, by-and-by, that these phe- nomena are manifest in the nervous system, as is distinctly seen in the web of a frog's foot, by the microscope, when the frog is intoxicated, by which we learn that alcohol, in a very dilute state, exalts, for a time, vital action, but is soon followed by a corresponding vital depression, from which the system is long in rallying, so that there is much less vital force generated in a given time with than without alcohol. Some suppose that alcohol, in small and frequent doses, is a tonic; but of this we have no proof. The property of tonic remedies, is to increase the vital contractility of muscular tis- sues, but especially of the bloodvessels, and in this we have, at all times, a relaxation of the muscular coat of the bloodvessels and a dilated state of the vessel. If a piece of nerve-tissue be subjected to the action of galvanism till it loses its excitability, and then is dropped for a moment into strong alcohol, the alco- hol seems to arouse the expiring vital forces, and it is again excitable by the galvanism; but if first acted upon by the alcohol till it refuses, it then falls into a state ef hopeless de- pression, from which no galvanism can ever arouse it. Small earth-worms and puppies are as surely killed by being intoxi- cated as if the brain was parboiled in an alkali. The mem- branes of the nervous centres are so tender as to allow the escape of alcohol through them, and the albumen of the brain is thereby coagulated and we have death as a certain result. Alcohol has one peculiar effect upon the blood, which I wish here to mention, as explanatory of something yet to come. When alcohol is taken continuously, it not only coagulates, to some extent, the albumen, as before shown, but it so contracts the red globules as to lessen their capacity for containing the hematine, or coloring matter of the blood, and it is squeezed out into the liquor sanguinis, where it retains the carbonic acid and rejects the oxygen presented to it at the lungs, and hence we have that dusky, dark-blue, cyanotic condition of habitual drunkards. Intoxication is manifestly, as the etymology of the term des- ignates, a condition of poisoning, and may, for convenience, be divided into three stages. The first is characterized by an increased activity of the heart's action; full, rapid pulse; flushed face and heated surface; with a general exaltation of all the organic functions; but it is most obvious that the encephalic centres are in a state of exalted function, evinced by the lo- quacity, rapidity and variety of thought, exhilaration and hilar- ity, and animated countenance and gestures. It is in this state that the old adage, in vino Veritas, is so clearly manifest in the prevailing inclinations and proclivities being made known. "The irritable and ill-tempered become quarrelsome, the weak and silly are boisterous with laughter and mirth;" they fancy themselves insulted, take fire within, rave, threaten, and then come to blows. Seneca spoke of them, as those who let in a thief at the mouth to steal away the brains--for the right hand is lifted against the dearest friend, perhaps the wife of his bosom, and in one rash hour performs a deed that haunts him to the grave. This stage is nearly allied to incipient phrenitis, or mania. This exaltation is not a sustained exaltation of ner- vous forces, but a perversion of them. If the stimulus be now pushed any farther, the second stage is ushered in, where delir- ium begins and all control over the thoughts is lost, and the man becomes confused and a little muddy, intellectually, (and sometimes physically,) with disordered reasoning powers and the victim of hallucinations, of vertigo, and double visions. Vomiting occurs here, from a poisonous condition of the brain- substance, and this is nature's effort to relieve herself; but si- milia similibus curantur gives him a little more alcohol. The third stage is a total cessation of sensorial power and action, a profound coma, and this may be of every degree, from the sound, deep sleep of nature, from which the patient may be aroused to partial consciousness, to that deep, stertorous breath- ing; sound, apoplectic coma; tetanic convulsions, and death. When a fatal case occurs, it is plainly one of apoplexy, or a breaking down of cerebral power by effusions; the countenance wears a disgusting, bloated, tumid, livid appearance; the eyes protruding, open, vacant, and staring; and the lips blue and everted; though, in some instances of alcoholic poisoning, it would seem that it was a result of the action of the poison on the nerves of the stomach, particularly those of the sympathetic system, thereby stopping the heart's action, the patient dying of syncope rather than asphyxia. This is a state of depression, not oppression, as in apoplexy, and, in this condition, he who bleeds his patient kills him. Alcohol, as already shown, has an elective affinity in favor of the brain and nervous system, as other articles have a preference in. favor of other organs or parts of organs. Its preference is first in favor of the cere- brum, the seat of intellect and reason. This is clearly evinced in the first stages of intoxication--quickened mental action, rapidity of thought, volubility of speech, and, temporarily, an increased mental power. It selects the cerebrum, as strychnia does the spinal cord; but push it to the second stage, and it reaches, by sympathy, the sensory ganglia upon which the cere- brum is superposed; and in the third stage, the medulla oblon- gata is involved, as evinced by the stertorous breathing, full, slow pulse, and a general sluggish movement of all the vital organs. The skin, the kidneys, and the lungs are now taxed to their utmost endurance, to eliminate this poison from the system; but, unfortunately, they succeed but partially, for the reason that the glands, the real scavengers of the system, refuse to take it up, unless it is the kidneys partially, and that is a dis- puted question; and small quantities of alcohol have been so intimately incorporated into the nerve-tissues as to pass out only by a change of nutrition. But alcohol being a ready com- bustible, attacks the oxygen from the blood and other tissues, and is thereby changed by combustion into carbonic acid and water, to which combustion the system is mainly due for its increased heat. I shall now pass to notice, briefly, some of the diseases of the brain and mind, induced by the abuses of alcohol, for it is the cause of more such diseases than all other causes combined. The delirium ebriosum of Darum I shall not notice, it being only an exaggeration of one of the ordinary forms of excite- ment in common intoxication, and will generally pass away in a day or two, if the wildness and ferocity of the patient be restrained by anodynes and gentleness. But there is a condi- tion intervening, upon a continued state of over-excitement of the nervous system, known by us all as delirium tremens, which is so named from the tremulousness and tremor of the muscles, which is always the result of exhaustion--the exhaustion of nervous fever. But delirium tremens may originate in two ways:--It may originate from a continued application of the stimulant till the battery of nervous power is exhausted and ceases to respond to the stimulant; or it may originate from a sudden withdrawal of the stimulant when the supply of nervous force is so nearly exhausted as to be unable to act without its wonted stimulant, and it is in the latter condition only when you may relieve the patient by goading the brain a little fur- ther, by giving him a little more whisky. But the cure is, to put the brain in splints, and keep it at perfect rest, till it can recuperate and generate natural forces enough to run this little piece of divine mechanism. This failure of nervous force is plainly manifest in every case of delirium tremens. There is little or no heat of the head or flushing of the face; the surface is cool and humid, and even chilly and cadaverous; the pulse is small, frequent, and weak; the temper is not violent, but there is anxiety and general apprehension of evil. Most phy- sicians have had patients attempt descriptions of this condition. One, I well remember, which was a vivid picture of a fiendish group of phantastic horrors and chilling agonies, which no pen could describe, even were it guided by the hand of a Dante. If some terrible monster enters your chamber at an unseasonable hour and threatens you, if you hear its footsteps and feel its hot breath, you arm yourself and go into the conflict, and every stroke does you good; but if you approach and strike it, and your good broadsword goes down through it as through a wreath of smoke, or it evades your grasp like a flake of down, or, like Milton's angels in the battle of Heaven, which, though a thou- sand times cloven, is still uncleft, you recoil from such an unequal conflict and yield yourself to such a deathless con- queror. And such being the nature of this dreadful affection, we have no difficulty in understanding how the habitual use of alcoholic liquors becomes one of the most frequent causes of insanity or settled derangements of the mind. It acts, as the statistics of lunatic asylums all go to show, both as a predis- posing and exciting cause, in a greater number of cases than all other causes combined. And this is due more to the pro- duction of a disordered state of the nutrition of the brain and nervous system, than in any other way. I might here go on and give the statistics culled from reports of the various asy- lums in the United States and Great Britain, but time will not permit. But by the law of hereditary tendency, or the trans- mission of condition, tendencies and appetites, it is remarkably manifest in the offspring of drunkards. Thus Plutarch says:-- "one drunkard begets another;" and Aristotle says, that "drunken women bring forth children like unto themselves." Diogenes said to a stripling, somewhat crack-brained and half- witted:--"surely, young man, thy father begot thee when he was drunk." Shakespeare seemed to recognize the law of he- reditary transmission of qualities so much insisted upon in the text:--"Come on ye cowards; ye were got in fear, though you were born in Rome." It is a matter of history, worthy our notice, that the child of an habitual drunkard was never known to attain to greatness. That there is a certain condition of exhaustion of nervous forces, a starved condition of the nutritive power of the brain, which, when transmitted, results in idiocy and imbecility, is settled beyond a doubt, and is accounted for upon principles much better known to science than the law of congenital nevus, or the marks produced upon children in utero, by impressions made upon the mind of the gestating mother. Dr. Howe, in his report to the legislature of Massachusetts, makes the follow- ing characteristic remarks:--"The parents of 300 of the idiots were ascertained, and 145 were reported as known to be drunk- ards. Such parents give a weak and lax mental constitution to their offspring, who are deficient in vital energy, and predis- posed, by their very organization, to cravings for stimulants." This is my argument exactly, that having a low vital energy, a deficiency in real brain force, they have a natural thirst for intoxicating liquors, a longing for something to goad up the brain till it will yield the amount requisite for the daily demand. If, now, we turn our attention to the inflammatory condition of the brain and its membranes, I presume every physician has a wide and melancholy field of illustration. Inflammation of the brain and its membranes is a usual concomitant of a pro- tracted debauch; or, if the unfortunate recovers short of actual inflammation, he is like to suffer from a protracted state of pas- sive congestion of the brain substance, producing that weight and heaviness of which we so often hear complained. But time does not permit me to dwell longer, and I must hasten on to touch upon a few prominent points in the diseases of the ali- mentary canal, produced by the too free and frequent imbibi- tion of alcohol. The effect of alcohol upon the healthy tissues of the stomach are more plainly manifest in the specimen I here show you, than I could illustrate in a whole evening's lecture. Here is the stomach of a drunkard, otherwise a healthy man. I took it from his body with my own hands. It is true, he suffered with all that train of diseases which accompanies such a life, but it was, emphatically, whisky and obesity of which he died and went to hades. The mucous coat is a perfect mesh of bloodvessels; it is thickened and indurated; the mucous coat is raised up, as it were, to protect the extremities of the gastric nerves from alcohol; there are ulcers and little abscesses filled with a hard granular pus, which has burrowed between the dif- ferent coats, almost dissecting them from their normal adher- ence to each other. Such is the havoc made in the stomach by alcohol; and the effect upon the duodenum and other bowels is like unto this. But it is useless for me to continue to enume- rate the different diseases of specific organs of the body, it will suffice to say, that it produces amyloid degeneration of the liver, cirrhosis, hydro-peritoneum, fatty liver, epilepsy, muscu- lar tremors, gastritis, pyrosis, various dyspepsias, and the lesions of the kidneys known as "Bright's disease," and last, but not least, alcoholism favors the production of nearly all other diseases, by lessening the power of resisting their causes, and contributes to their fatality by impairing the ability to tolerate and overcome them. Drunkards readily succumb to inflammatory diseases of every variety. Surgeons are always desirous of getting union by first intention, which union they never get in habitual drunkards, on account of the impaired plasticity of the blood. But some are, doubtless, ready to ask the question:--Has alcohol no vir- tues as a remedial agent? I answer, yes, it is indeed a saver of life unto life; but it is then a benign agent, as a poison, as a medicine, and all medicines are poisons. There are a thou- sand instances and conditions wherein this powerful arterial stimulant may be used in restoring the injured or wounded from severe shocks, or sustaining the failing life force, or fanning the expiring flame of life into an increased fervency and brill- iancy. In chronic diseases, in low fevers, arid in extensive superficial burns where, by the direct action of fire, the tem- perature falls to a degree below the point consistent with vital- tality, a little stimulant may be administered with magic results in sustaining the heart's action and nerve forces till reaction is manifest. But such administration should always be under the direction of an intelligent physician. There formerly existed some doubts whether the human sys- tem could not keep up a sustained effort of its physical and intellectual powers by the aid of alcoholic stimulants longer with than without them, whether or not it did not increase the aggregate of man's endurance. But however many doubts might have lingered in the public mind formerly, it seems that the history of the last five years would have dispelled them all. Our soldiers were not goaded on to victory by any such de- grading impulses. They underwent exposures and privations, endured hardships and fatigues, made wearisome marches be- neath the burning rays of a tropical sun, exposed to the dis- eases of a high latitude, all without a murmur. They faced enemies, fought battles, and achieved victories, the like of which the world has never known--they carried bibles, not bottles-- a sound conviction of a noble duty was their only stimulant. But does not alcohol increase man's endurance in a continued mental effort? With most persons it produces a temporary exaltation of mental activity, lighting up the scintillations of genius into a more brilliant flame, or assisting the prolongation of a single mental effort when the powers would otherwise be exhausted; but it must be remembered that it it is not in any brilliant corruscations or unnatural irradiations of wit or humor in which the merit lies, but it is in the continued fervor of the glow which drops the rays of light into the dark corners of the world's great heart, lighting it up with the lamps of wisdom, and sowing seeds which bring forth the golden harvest. If spirits would make poets and orators, the world would be full of them. The lights of genius may be untimely burnt out and forever extinguished, as in the case of Mozart, and Haller, and Byron, and Poe. These men gave manifesta- tions of music and poesy in spite of, and not on account of, alcohol. Call Homer from the dead, interrogate that blind old bard of Scio's rocky aisle, as he rolled his quenched eyeballs to find a ray of light, and ask him if that mellifluous epic which he warbled through the listening cities of his native seas, was the fruit of alcoholic potations; and then Milton, a second Ho- mer, but a greater than the first, was it alcohol or celestial lights which shone inward and raised up things invisible to to mortal sight. Do the works of Locke and Bacon bear the impress of a heated brain? Are they volcanic productions? No sir, the Novum Organum and the Essay on the Understand- ing, give evidence of minds purified by a refiner's fire. The brain is the organ of the mind, and whatever interrupts the nutritive functions of that organ or changes its sensitive, delicate textures, prevents the mind's ready response to moral ideas and lessens the power and correctness of all intellectual operations. Thought is the true standard of intellectual excel- lence. 'Tis thought that has said to the wilds of America, blossom, and almost instantly it has become as the garden of Eden. It says to the mountains, be ye opened, and instantly its bowels of rock are blasted out. 'Tis thought that outstrips the wing of lightning, and speaks like the voice of God. It defies volcanoes and storms, and laughs and makes out warrants and executions in its burning path; it tameth the tiger, and maketh a plaything of the lion. 'Tis this, of all things, which most challenges our admiration. We look at the idiot, or even the temporarily insane, and feel that it is a terrible thing to have the reason extinguished, or that some crushing power should rest upon the intellect, paralyzing it. It would be no compensation for us to know that our children would grow up with all the beauty of an Antinous or the giant proportions of an Apollo, did we not expect intelligence to accompany their maturity. Even the club-footed and deformed are loved and courted, if but this God-like quality is left them--the power to think. I, for one, believe in an aristocracy, social castes, and an hereditary nobility. But these distinctions should not be erected upon the crumbling basis of wealth. It should be an aristocracy of intellect, a caste of thought, a nobility of mind, and it is plainly the duty of physicians, as champions of moral ideas and devotees of science, to enlighten the people upon the action of every agent which tends to corrupt the fountains of virtue in themselves, or to fetter and trammel the intellect of their offspring. And we have but to cast around us, to see that alcohol, more than all other influences, tends to corrupt and pollute the purest avenues of society, rendering those minds vulgar and plebeian which otherwise would be dignified and noble. "This most excellent canopy, the air, this brave, o'er- hanging firmament, this majestic roof fretted with olden fire I What a piece of work is man: how noble in reason; how infi- nite in faculties--in form and moving, how express and admira- ble; in action, how like an angel; in apprehension, how like a god; the beauty of the world, the paragon of animals." We delve deep in the mysterious organic structure, but the glitter- ing scalpel throws back the reflection, "there is a God, who made all this." But the correction of moral evils belongs not to science; and leaving the subjects of death--the grim ferry- man--and man's accountability to God to the man of ethics, I shall offer but a single reflection more. I desire not to take the role of Mentor, nor wear the Nessus' shirt of self-conceit; but I would be understood. What are we to do? We cannot ignore the use of this valuable agent of the text; in such attempt we but fly from Scylla to be wrecked on Charybdis. But guided by the light-house of science, and steering our bark in the middle of the channel of truth, we may use it with caution, at all times exercising a wise discretion as to when and how it shall be administered, if not, we will in- crease human sufferings, while our mission is to ameliorate them. The physician goes by the ditches and gutters of pollu- tion, but not like the arrogant priest and haughty Levite, who did not so "much as look that way," or walked on the other side, but like the good Samaritan, he may lift mankind from the trenches of vice as well as the touch of pain and disease. He knows their foibles and failings, and if he is a physician and treats the whole man, he addresses his remedies to the failing part, be that attribute or organ. But alcohol has an action directly upon our profession, one of which I have not spoken. There is an aspersion which comes against us from the great heart of the people, which is more loathsome than the sores of Lazarus, or the leprosy of Naaman--one which can neither be hid in "Abraham's bosom," nor purged away in the pool of Siloam--it is this, that the profession, as a profession, is under the ban of intemperance; that the footsteps of the drunkard are wont to be heard in the chambers of woe. Ah! be it said, to our everlasting shame, that the pestiferous breath of alco- holic potations is exhaled around the bed of the dying. Will we not, as a profession, arise and shake this stain from our garments, as the lion shaketh the poisonous vapors from his mane, and hurl back the foul aspersion into the faces of those who make it. Let us be willing to labor for the advancement of the profession--retarded by individuals, it may be, but dis- graced it shall never be.

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Practical Dissections. By Richard M. Hodges, M.D., formerly Demonstrator of Anatomy in the Medical Department of Harvard University. Second edition, thoroughly revised. Philadelphia: Henry C. Lea, 1867. pp. 285. This is a plain, concise, and convenient guide to the student in his dissections. It is not a substitute for a treatise on ana- tomy, but just what the student needs for use in the dissecting room. For sale by W. B. Keen & Co., 148 Lake St.

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PASSAGE OF AN ANATOMY ACT IN PENNSYL- VANIA. Within the last week the Legislature of this State has passed the following important act, which, it is understood, will receive the approval of the Governor: An Act for the Promotion of Medical Science, and to Prevent the Traffic in Human Bodies. Section 1. Be it enacted by the Senate and House of Representatives of the Commonwealth of Pennsylvania, in General Assembly met, and it is hereby enacted by the author- ity of the same, that, any public officer having charge or control over the same, within the limits of Philadelphia and Allegheny Counties, shall give permission to any Physician or Surgeon of the same county, upon his request made therefor, to take the bodies of such persons as are required to be buried at the public expense, to be by him used within the State for the advancement of Medical Science, preference being given to Medical Schools, public and private; and said bodies to be dis- tributed to and among the same, equitably, the number assigned to each being proportioned to that of its students; provided, however, that if the deceased person, during his or her last sickness, of his or her own accord, shall request to be buried; or if any person claiming to be, and satisfying the proper authorities that he is of kindred to the deceased, shall ask to have the body for burial, it shall be surrendered for interment; or, if such deceased person was a stranger or traveller, who died suddenly, the body shall be buried, and shall not be handed over as aforesaid. Section 2. Every Physician or Surgeon, before receiving any such dead body, shall give to the proper authorities sur- rendering the same to him, a sufficient bond that each body shall be used only for the promotion of Medical Science within this State, and whosoever shall use such body or bodies for any other purpose, or shall remove the same beyond the limits of this State; and whosoever shall sell or buy such body or bodies, or in any way traffic in the same, shall be deemed guilty of a misdemeanor, and shall, on conviction, be imprisoned for a term not exceeding five years, at hard labor in a county jail. Similar legislation has been three times, at least, urged upon our Legislature before, unsuccessfully. Misunderstanding, prejudice, and technical delays, have defeated it. This time, the College of Physicians, of Philadelphia, upon the motion of Dr. W. S. Forbes, gave its official sanction to the effort. A committee, consisting of Drs. Forbes, Agnew, and II. Harts- horne, visited Harrisburg on behalf of the College. Especially through the exertions of Senator Wilmer Worthington, M.D., the act was rescued from burial in Committee, and passed *through the Senate. In the House, it was called up by Mr. Freeborn, and passed within a few days. Thus one of the ob- stacles to medical teaching in Philadelphia is removed, and we are, in this respect, on the same footing as New York. It is a not uninteresting fact, that the passage of a similar bill, the ".Warburton Act," by the British Parliament, more than forty years ago, followed the agitation resulting from the discovery of the murders perpetrated by Burke and Hare to obtain sub- jects for sale, at lower prices than, from want of this bill, they have lately commanded here.

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FOX RIVER VALLEY MEDICAL ASSOCIATION. The Association met at Turner Junction, DuPage Co., Ill., on the 1st of April, and was called to order by the President, Dr. Winchester. After the ordinary preliminary business, Drs. Hard, LeBaron, Winchester, and D. W. Young were elected delegates to the State Medical Association; and Drs. Hawley, Hard, Dean, and Hagar were elected delegates to the American Medical Asso- ciation, with power each to fill vacancies from the members of this Association. Dr. Hard delivered an address upon the influence of evil habits in the production of disease, with special reference to the use of tobacco. The address elicited a lively discussion, which was participated in by all the members present. Drs. Hawley, Winchester, and Cushing, each reported an interesting case of injury of the head, one of which proved fatal, one recovered, and one still under treatment. Dr. Hard reported a case of melanotic tumor, which had been twice removed within three months. A discussion then followed upon obstetric practice, by Drs. Hawley, LeBaron, and Woodworth. The Secretary, Dr. Cushing, being about to remove to Cali- fornia, tendered his resignation, and Dr. Hard was elected to the vacancy. The Association passed, unanimously, resolu- tions of respect for the retiring Secretary. On motion of Dr. Eddy, the Association adjourned to meet at Turner Junction, on the first Monday of July next. C. CUSHING, M.D., Secy.

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of a r i PS t i PS a. PULASKI COUNTY (IND.) MEDICAL SOCIETY. Pursuant to a call of the physicians of Pulaski and adjoining counties, the following gentlemen assembled in Winamac, Ind., April 2d, 1867, for the purpose of organizing a Medical Soci- ety:--F. B. and A. McD. Thomas, A. M. Pearson, James To- lerton, H. Kittinger, Winamac; J. W. C. Eaton, and N. S. Hazen, Pulaski; C. G. Hartman, Francisville; James H. Smith, Harrison Township; I. B. Washburn and J. B. Moore, (stu- dent,) Star City; L. D. Glazebrook, San Pierre, Stark Co; and James Thomas, Royal Centre, Cass Co. On motion, F. B. Thomas was chosen Chairman, and I. B. Washburn Secretary. On motion of Dr. Jas. Thomas, a committee of five was ap- pointed to draft a constitution and by-laws. The Chairman appointed Drs. Glazebrook, Hartman, Pearson, Tolerton, and A. Thomas. The committee reported a constitution and by- laws in the usual form, which were adopted. After the adoption of the constitution, the Society proceeded to elect officers, which resulted as follows:--President, F. B. Thofnas; Secretary, I. B. Washburn; Treasurer, A. M. Pear- son; Censors, L. D. Glazebrook, James Tolerton, and A. McD. Thomas. The Society adopted a fee bill, equalizing the charges for professional services, and harmonizing with those of neighbor- ing societies. Dr. Washburn offered the following resolutions, which were unanimously adopted:-- Whereas, From the teaching and practice of a certain class of self-styled physicians, the unnatural crime of procuring abor- tion or miscarriage, for the purpose of gratifying the lust, am- bition, or caprice of those who do not wish to bear maternal responsibilities; therefore, Resolved, First, That members of this Society will in no.case countenance the practice, except to save life, and then only after consultation with a physician of good standing, when such consultation is possible. Resolved, Secondly, That members of this Society who may be cognizant of the procuring of criminal abortion, apprise the Grand Juries of their respective districts of the facts in the case, looking to a speedy prosecution of the'same. On motion, Dr. L. D. Glazebrook was appointed on essay, and of the proceedings of the Society for publication in the Chicago Medical Examiner, Chicago Medical Journal, and Lancet Observer. On motion, adjourned, to meet in Winamac, the second Tues- day in June, 1867. F. B. THOMAS, Prest. I. B. Washburn, Secy.

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HYDROPHOBIA. SUGGESTION AS TO THE TREATMENT OF HYDROPHOBIA. I would suggest one grand experiment for the cure of hydro- phobia; that is, to trephine and subject the brain to pressure, and thus in a degree suspend the functions of the nervous sys- tem. Now when we relieve the excessive nervous irritability, there is reason to hope that nature will be able to eliminate the poison, or else its effects cease before the patient is exhausted. It may be said that this is a dangerous remedy, but a dangerous remedy may be required for a dangerous disease. AMOS SAWYER. Hillsboro, III., March 21st, 1867.

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EXTRACT FROM OBSERVATIONS UPON ANAESTHE- SIA OF THE CORNEA AND RADIATING FIBRES OF THE IRIS OCCURRING WITHOUT INTRA- OCULAR TENSION. By JOS. S. HILDRETH, M.D., Opthalmic and Aural Surgeon to Cook County Hospital, Chicago, Ill. By anaesthesia of the cornea I here refer to that diminution of its sensitiveness to touch which may exist without apparent organic disturbance of the part. By anaesthesia of the radiating fibres of the iris, to a condi- tion of this membrane which, without mechanical complication or apparent organic change, prevents the pupil from properly responding to the influence of atropia or light. The degree of anaesthesia may be ascertained by gently touching the cornea obliquely with the point of a small, soft camel's hair pencil, previously wet and stripped quite dry; or the point of a small twisted roll of unsized paper slightly moistened. This should not be repeated more than once or tw'ice during a minute, lest a degree of toleration be established which would interfere with correct appreciation. The iris is to be tested by using a given number of drops of atropia in solution of definite strength.* But its dilatability does not always correspond to the state of the cornea, being in some cases greater with the same degree of anaesthesia than in others; yet, the amount of atropia and time required for dila- tation are valuable diagnostic guides. The influence of light should also be noted. * Four grains to the ounce. These pathological conditions may exist from a slight to a very marked degree, and doubtless are caused by a certain abnormal state of the ciliary apparatus, which may result from intra-orbital, cranial, or spinal causes; and possibly, in some cases, be idiopathic. It can also be temporary, as it were, spasmodic, or become permanent. The influence exerted by this affection upon other diseases, especially panniform and ulcerated keratitis, infiltration and sloughing of the cornea in purulent ophthalmia, panus, and some forms of atrophy of the globe, engages particular atten- tion. When slight, of recent origin, or spasmodic, it may, in some cases, be relieved by medical means only; but, if existing to a high degree, or of long standing, division of the ciliary ring becomes necessary. The following clinical facts are taken from the records of the United States Eye and Ear Hospital. All were operated upon without ether or chloroform. Furrow, set. 29. April 13, 1865. Left eye. Cornea con- siderably anaesthetized, panniform, and centrally ulcerated; pupil only slightly influenced by atropia. No apparent change of iris, no tension of globe; acute pain in and about the orbit. Division of ciliarv riner.* * The point of operating was in all of these cases between the external and inferior recti, unless repeated, when it was between the inferior and external. The corneal anaesthesia was at once relieved, and the pupil became dilated in thirty minutes, though no atropia had been used for more than twenty-four hours. Pain speedily abated. June 19. From the date of the operation there had been no return of pain; the pupil readily responded to atropia, but was not fully susceptible to light. The reflex movements were more marked from than to this side. No corneal anaesthesia remained; its panniform condition had greatly improved, and ulceration healed. Periphery of retina apparently unimpaired. General and local medical treatment previous to the opera- tion had failed to afford relief. Crippen, aet. 20. April 13, 1865. Right eye. Cornea pan- niform, ulcerated, and considerably anaesthetized. Pupil slightly influenced by atropia. No other affection of iris; no tension of globe; severe pain in and about the orbit. Ciliary ring divided as in preceding case. Corneal anaesthesia immediately disappeared, and the pupil dilated in ten minutes, though no atropia had been used for twenty-four hours. Pain in orbit at once relieved, and from surrounding parts in a few days. June 19. The corneal anaesthesia had not returned; the pupil dilated easily, and responded to light. Ulceration had healed, and panniform condition was improving. No return of pain. Periphery of retina unaffected, and reflex movements of irides equal. Medical treatment had failed to afford relief. Lamont, set. 49. April 26, 1865. Left eye. Pain of vary- ing intensity, radiating to corresponding supra-orbital and coronal regions. Cornea anaesthetized, and iris only feebly influenced by atropia. Ao tenison of globe. General and local medical treatment, with frequent paracen- tesis of the anterior chamber, had failed to materially improve these conditions. The ciliary muscle was divided obliquely backward from its corneal attachment, about four and a-half or five millimetres. Corneal anaesthesia was at once largely diminished, and the pupil dilated in about twenty minutes. Pain in the orbit re- lieved within a few minutes, and in coronal and supra-orbital regions in forty-eight hours. No atropia had been used within twenty-four hours of the operation. In the course of ten days, the pupil, having been allowed to contract again, was found beyond the influence of atropia. The corneal anaesthesia was increasing and pain returning. May 13. The ciliary muscle was again divided from its anterior insertion obliquely backward about six and a-half or seven millimetres. The immediate effect was, as before, to remove the corneal anaesthesia, and to allow the pupil to dilate in about twenty minutes, from the effects of atropia that had been used forty- eight hours previously, as none had been employed since that time. October 16. The corneal anaesthesia had not returned, the pupil was perfectly free, and responded to the action of atropia and light. Its contraction by reflex action was not so perfect as that of the opposite side. Ulceration of the cornea had healed. Peripheric vision, with dilated pupil, was good. The imperfect results following the first operation are at- tributed to imperfect division of the affected parts of the ciliary ring. But it is probable all of its effects would not have been lost, as they were, had the use of atropia properly been kept up. Hughes, aet. 23. Right cornea anaesthetized, and the pupil slightly affected by atropia. Medical treatment, with repeated and systematic paracen- tesis of the anterior chamber, slightly influenced these condi- tions. May 11. The pupil contracted; was not affected by atropia, and the cornea was still anaesthetized. No other apparent affection of the iris, and no tenison of the globe. Division of the ciliary ring, wflth the immediate effect of removing the corneal anaesthesia, and causing the pupil speed- ily to dilate, though no atropia had been used for twenty-four hours. June 19. The pupil has been dilatable since the operation, and anaesthesia of the cornea has not returned. Peripheric vision of this eye apparently good, and reflex movements of irides are equal. Pemberton, aet. 29. March 18. The cornea of the right eye anaesthetized, and the pupil feebly influenced by atropia; considerable pain in and about the orbit. No intra-ocular tenison. The ciliary ring was divided, which immediately removed the anaesthesia of the cornea and caused the pupil to speedily dilate. No atropia had been used for twenty-four hours. June 17. The corneal anaesthesia has not returned; the pupil dilates readily and responds to light. Periphery of retina unaffected, and reflex movements of irides equal. The above cases represent the pathological conditions under observation, and show the results of division of the ciliary ring upon them after general and local medical treatment, aided in a number of them by frequent and systematic paracentesis of the cornea, had failed. In no instance did evacuation of the aqueous humor affect the anaesthetized condition of the cornea or allow the pupil to dilate, though atropia was at the time freely used. The influence of these conditions upon some forms of keratic disease is also above made apparent. In the following case partial atrophy of the globe and cor- neal anaesthesia were both relieved by division of the ciliary ring after iridectomy had failed. Hamilton, aet. 20. Left eye. Large leucoma, with anterior synechia; remainder of cornea nebulous and anaesthetized. Slight atrophy of the globe. Iridectomy, September 15, 1865. October 11. Anaesthesia of cornea remains, and atrophy of globe unchanged. Division of the ciliary muscle caused the corneal anaesthesia to disappear within forty-eight hours. November 6. Globe is firm, and cornea normally sensitive. The form of corneal insensibility under observation is usually uncomplicated; but it may co-exist with intra-ocular tenison, as in the following instance: Johnson, get. 25. Left eye. Staphyloma of choroid; iris dark and disorganized; pupil contracted and bound by poste- rior synechia; cornea anaesthetized; intra-ocular tenison well- marked. October 30. Iridectomy followed in fifteen minutes by divi- sion of the ciliary muscle. After the removal of one-sixth of the iris from its pupillary to the ciliary margin, the cornea remained anaesthetized as be- fore, but was immediately relieved by the second operation. In two other cases the pupil quite undilatable, yielded upon administering ether to a high grade of relaxation. Dilatation became quite full in one, was easily maintained by atropia, and permanent relief followed. Only partial in the other; on discontinuing the drug, the pupil contracted and refused to dilate as before. Several times I have observed this condition of the iris to be carried by reflex action to the opposite side. So that, upon relieving the eye most affected, it gradually disappeared from the other. In some instances a certain grade of anaesthesia has been modified by well dilating the pupil, which accounts for the favorable influence of this remedy in keratic affections. Von Graefe remarked, in 1859, that if the pupil readily dilates by atropia, there would be less liability to suppuration after extraction of cataract, or words to that effect. That condition producing the corneal anaesthesia, specially described in this paper, undoubtedly often has been instrumen- tal in producing unfavorable results in this operation, and it should be removed before flap extraction. The early diagnosis of that condition represented by corneal anaesthesia and iritic insusceptibility to atropia, is of the great- est importance in purulent ophthalmia, as it is frequently fol- lowed by infiltration and consequent sloughing of the cornea or ulceration from the epithelial surface without previous infil- tration. If the narrow and dense band of conjunctiva immediately surrounding the cornea remains intact, infiltration of the sub- epithelial structures will precede sloughing; but if this conjunc- tival band early become infiltrated or disorganized, sloughing from the surface soon follows, though the parts beneath may not be infiltrated. I would operate in all such cases when anaesthesia of the cor- nea could not be relieved by atropia, and especially when the pupil had become undiltable, and then maintain the, effects of the operation by the use of atropia. As stated in a previous paper, this operation should not wholly be relied upon in such cases. Other means must also be used to control inflammatory action, the purulent discharge, and the chemosis. By its proper and timely use, the cornea can be saved when all other known means combined would inevitably fail. The successful treatment of panus by syndectomy and puru- lent inoculation involves one of the causes of its original produc- tion--imperfect nutrition of the deep tissues of the cornea. From results already recorded, and experiments in progress, it is evident pannus may yet be successfully treated without resort to purulent inoculation. As this paper is intended only to report certain clinical facts, theoretical deductions, as far as practicable, have been omitted.--Transactions of the Am. Ophthalmologic al Society.

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Inhalations in the Treatment of Diseases of the Respiratory Passages, particularly as affected by the use of atomized fluids. By J. M. DaCosta, M.D., Physician to Pennsylvania Hospital; Fellow of College of Physicians and Surgeons, etc., etc. Philadelphia: J. B. Lippincott & Co. 1867. This is a monograph of 86 pages, very neatly printed and bound. It contains five chapters on the following topics: 1st. The History of Inhalations and the Apparatus Em- ployed. 2d. The Mode of Administering Inhalations. 3d. The Penetrability of Atomized Fluids into the Air- Passages. # 4tli. Doses of Medicine for Inhalations. 5th. Therapeutic Considerations. It is a work of real value. For sale by S. C. Griggs & Co., 148 Lake St.

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ARTICLE X. KERNEL OF CORN IN THE TRACHEA.--TRACHE- OTOMY.--EXPULSION OF FOREIGN BODY. By E. ANDREWS, M.D., Prof, of Surgery in Chicago Medical College. Mr. S., of the town of M., brought me his child, which had, a few days previously, been playing with some corn-cobs, and had been seized with a sudden fit of strangling and coughing. The child was feverish, coughed constantly, had little sleep, and showed a distressed and anxious expression of countenance. The foreign body could be distinctly heard to rattle up and down the trachea with every inspiration and expiration. I administered ether to anaesthesia, and cut down upon the trachea above the isthmus of the thyroid body. After clearing the sur- face of the organ so as to have a distinct view. I inserted a scalpel and severed three or four rings of the trachea', making a perpendicular slit from the thyroid body to the cricoid carti- lage. Drawing asunder this opening the next expiration drove the kernal of corn up into the orifice, where it hung an instant and was then sucked in again and disappeared. The second expiration brought it up again and expelled it with such force that it flew two feet from the patient. The incison was then closed with adhesive straps, and the patient made a good recovery.

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NEW YORK MEDICAL JOURNAL ASSOCIATION. Stated Reunion, January 11, 1867, Dr. Gurdon Buck in the Chair. PRESENT POSITION OF AURAL SURGERY. Dr. Roosa remarked that the present method of examining the membrana tympani was a most decided improvement upon the somewhat familiar routine of the old practitioners. This revolution began with Prof. Troltsch's suggestion of the con- cave mirror, o'f six-inch focus and having a small central aper- ture for the convenience of the observer. Prof. T. combined with this the tubular speculum. , There were those who even believed that the simple mirror would supersede Dtsormeaux's endoscope. Another grand advance had been made in our appreciation of the real objects of interest, which present themselves for in- spection. Formerly only the handle of the malleus and the periphery of the drum challenged attention. Now the triangu- lar light spot, which effect, as first shown by Politzer, is due to the traction of the handle of the malleus upon the drum in an inward direction, was taking its proper rank in professional estimation. For the benefit of those who had given but little attention to aural science, he would pass around the illustra- tions of Dr. Politzcr's work, for here this spot was prominently brought forward in the different phases of health and disease. He would also accompany those plates with certain photogra- ' phic illustrations, obtained from tylunich, in which the ossicula auditus and other parts of the ear were very well represented. The last number of Guy's Hospital Reports, as may be seen by a reference to the shelves of the Association, likewise exhibits perforation of the drum, although he objected to the term nor- mal drum, as applied to one taken from the dead subject. Then, again, the eustachian catheter, nowithstanding the as- sertion that Mr. Turnbull, in London, had killed two patients by its use, was steadily growing in the confidence of surgeons. Apropos of the danger to be encountered, he would answer with the experience of Continental and American surgeons, by whom this most excellent means of diagnosis was highly lauded. The only objection of value, and this a probable accident merely, was a rupture of the mucous membrane, which might produce an emphysema transient in character. Nothing alarm- ing, so far, had occurred in his hands to induce him to abandon the instrument, unless a case of fainting might be regarded as an exception. Certain it is that the catheterism of the eustachian tube is an operation frequently performed in the Eye and Ear Infirmary, and in private practice, without any feeling of dread. The value of the procedure is demonstrable in chronic catarrhal inflammation of the middle ear (the chronic myringitis of Sir William Wilde), but it is nob applicable to the treatment of a very rare affection, to wit, the stricture of the tube. Bougies, for the strictures above alluded to, were now like- wise benefically used. In this mode of treatment, Dr. Francis Simrock, of this city, had a large experience. With regard to Politzer's method of inflation too much can- not be said. The late Mr. Toynbee proved that the eustachian tube was closed except during the action of certain muscles con- cerned in deglution; Politzer practicalized the discovery by requiring the patient to swallow, while the surgeon forced air through a tube, placed in one nostril while the other was closed. In this way, the rush of-air through a ruptured membrane was readily appreciated, and at once became a valuable diagnostic sign. If during the experiment the membrana tympani chanced to be ruptured, there need be no apprehensions, since the wound thus caused very readily healed. Dr. R. spoke warmly of this method in those subacute cases, of which the following was a type, and which he would relate as exhibiting its success: A boy of scrofulous constitution, exposed to the fiction of cold, "gets," in common parlance, "his ears stopped up." This deafness promising to be permanent, he is treated according to the best intelligence of the period, by cauterization of the throat and removal of the tonsils, but without benefit. His physician, as soon as Politzer's method was promulgated, sent for the boy, applied the principle, and was rewarded by the fact that the patient heard an ordinary conversation in five minutes. This patient was again attacked a number 'of months after, and again in like manner relieved. Politzer's method, however, was not valuable in chronic peri- pheral thickening, as shown by change in form of the light spot, etc. Its good effect was chiefly manifest in the removal of mucous accumulations which might take on structural changes. In perforations, Politzer's apparatus had been made available in thoroughly cleansing the canal established as a result ^f in- flammation. This was accomplished by filling the affected ear with warm water, afterwards stuffing the meatus with raw cot- ton. The tube, cavity of tympanum and external meatus, were thus thoroughly washed out. The nebulizer was now used in the therapeutics of aural dis- eases. Dr. Bishop's apparatus for nebulizing the mouth of the eustachian tube very often sends fluid instead of spray, but this freak sometimes being of advantage could hardly be urged as an objection. For the injection of iodine he had found Butties's inhaler a very useful addition to Politzer's apparatus. Dr. R. alluded to and exhibited a few other appliances, upon the claims of which hesdescanted at some length. Artificial membrane tympani were now. found more generally applicable than before supposed. Mr. Toynbee's disc of rubber being liable to' separate from its attachment and act as a for- eign body in the ear, has been modified by a German, who has ended off the little wire with a spiral arrangement. The disc is secured by one or two of these closely fitting coils, in the same manner that a cork is by the cork-screw. In one case in Dr. R.'s experience the hearing distance was prolonged, during .the use of these dies, from one or two inches to two feet, which was certainly a very comfortable gain to the patient. Then, again, the otoscope, for listening to the passing of air into the middle ear, is a refinement in our means of diagnosis unknown to our predecessors. We have now also better defined ideas regarding the aftergrowths in the ear. What Mr. Toyn- bee was pleased to call exostoses of arthritic or syphilitic ori- gin, are now accepted as being due to a primary periostitis. We expect, therefore, to prevent their formation. As an earnest, indeed, of the benefits to be, derived from the future cultivation of this inviting field of inquiry, it is observed that aural polypi, which are now regarded as exuberant granulations merely, are much less frequently met with than they were ten years ago. The change in nomenclature points out more exact know- ledge of aural diseases, since such terms as otorrhoea, myringi- tis, etc., which only mislead the student are falling into disuse. We now know that the ceruminous secretions and the inflam- mation of the middle ear are independent of each other. The literature of the subject is now no longer meagre; publi- cations of high authority are readily attainable in London, Paris, Vienna, Munich, and New York. In addition to these facili- ties, we have a German quarterly devoted to the consideration of the topic. In fact, careful, earnest students are pursuing the j^ranch with enthusiasm, and have already been rewarded by the most brillant returns. For the matter of that, statis- tics show that, exclusive of the chronic cases inherited by us from a previous generation, we are not more unsuccessful in our therapeutics here than in other parts of the body. Dr. R., in the course of his remarks, gave some very inter- esting statistics, collected by himself and Dr. G. M. Beard in the asylums of New York and Hartford, the object of which was to fix the relation sustained by the pharyngeal mucous mem- brane towards the membrana tympani in the causation of con- genital deafmutism. These, he promised, should be published in due time. He also maintained that the difficulties attendant upon the study of the disease were not as great as generally supposed--they need not interfere with the duties of the most active practice. Dr. Ellsberg called attention to the omission on the part of Dr. Roosa to mention the importance of inspecting the post- pharyngeal space. The element in diagnosis, in the course of Dr. R.'s extemporaneous remarks, had, no doubt, temporarily- escaped the memory of the speaker. Dr. Roosa acknowledged his indebtedness t(c) the gentleman, and made a few remarks upon rhinosophy. The Association then adjourned.

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ARTICLE XIII. REMARKS ON DIFFERENT SUBJECTS. By N. HOLTON, M.D., Buda, Ill. Read to the Members of the Military Tract Medical Association, Dec. 11, 1866. After amputation by what is known as the flap operation, there is a redundancy of muscle in many cases. This I have often seen, both in civil and military surgery, and, because of this happening to me, I thought it might or had occurred in the experience of others. It does not succeed well if the in- teguments are drawn too tightly to cover the muscles in coap- tating them, and, on this account, it becomes necessary to reamputate the muscles before the integuments can be properly adapted together so as to secure union by the first intention. It occurred to me that, in most cases, by grasping the parts from which the flap was to be made, and retracting the skin, the difficulty above spoken of might be avoided. In some cases of amputations by the flap method, the weight of the flaps has been thought to be an objection. This objec- tion, perhaps, would not have as much weight , in civil as mili- tary practice, but some in both. In a case where I amputated below the knee, some weeks ago, the posterior flap being formed of the muscles of the calf of the leg, and this, being the principal flap, was quite heavy. If this flap is allowed to draw down its whole weight, it will be quite sure to destroy the vitality of the tissues where they are drawn across the tibia, and, consequently, result in sloughing. This was likely to be the result in the case above alluded to, but upon being carefully supported by a double inclined plane curved splint, the patient went on well again. They may be supported by cushions or pillows sufficiently for all practical purposes. In cases where there is considerable suppuration or erysipelatous tendency, I am in the habit of prescribing the muriated tincture of iron freely, and have never had patients affected with traumatic erysipelas or hospital gangrene where it was used as a prophylactic. I am indebted to Prof. E. An- drews, of the Chicago Medical College, for this idea. Two Cases of Spina Bifida. On June 29th, 1866, I was called to attend Mrs. M. in her first labor, and, after a little more than usually hard time, she was delivered of a large male child, affected with spina bifida. The unusually hard labor was caused, I thought, by the cord being around the body just above the pelvis. Instead of a tumor on the back, the tissues were gone considerably below the surrounding parts in the region of the two first lumbar ver- tebrae, and the posterior half of the vertebrae seemed to be gone. The parietal and frontal bones were less ossified than usual, leaving the parietal bones widely separated along the median line and extending into the frontal bone as far as a level of the superciliary ridge. Otherwise, the child was well developed. I thought that if the parts could be sufficiently supported, that lacked development, or had lost their integrity, that the func- tion of organization might go on and the cranial bones become ossified. To carry out this, I ordered compress and bandage, and, under this management, the ulcer on the spine became cov ered with a thin, parchment-like membrane, but, perhaps for want of thoroughness on the part of the parents, or from some other cause, the tumor grew and the contents of the cranium protruded more and more beyond the bones. About the 10th of October, there came a hole in the tumor of a very minute size, and on the 14th the child died. There was nothing uncommon about the other case, and it did not live but a few weeks. It was accompanied by talipes, a very usual thing, I believe, in spina bifida. The mother of the first case was severely frightened by a horse kicking while she was in the buggy, three months before her accouchement, and the second fell on the ice in the early part of gestation, hurting her back severely. Whether these, or the fact of the cord being tightly drawn around the body of one child, had anything to do with these cases or not, I am not satisfied. Prof. D. Brainard, of Rush Medical College, in the cata- logs for 1847 and 1848, says, "Cure of Spina Bifida by Injec- tions of Iodine." But, unfortunately for the practice, Dr. Brainard's case soon after died; and as that was so long ago, and the practice not yet confirmed, I suppose it is a failure. Can these cases be cured? I confess I do not know. In conversation with Dr. II. Nance, of Kewanee, upon spina bifida, he said there was a case in his town, in the last cervical or first dorsal vertebra, of small size, in which the tumor was covered with a strong membrane; and that the child was doing well, could walk, and do. anything that other children do. A Case of Chronic Inflammation of the Urinary Organs. This, I wish to include the kidneys, ureter, bladder, and urethra. On the 11th of September, 1866, I was consulted by Mr. II., for what he called gravel, and, on inquiry, I elicited the follow- ing history:--lie had been in the cattle business, in Missouri and Texas, through the season, almost constantly riding on horseback, and had noticed a diminishing stream of urine, till, suddenly, he was unable to pass it at all, (this was two weeks before I saw him,) and compelled him to consult a physician, who relieved him with the catheter. When I first saw him, he could not pass urine, and he was again relieved by the use of the catheter, without difficulty; but the urine was largely mixed with blood, and some bloody mucus was entangled in the eyes of the catheter. At this time, there was very slight constitu- tional disturbance, and, after a careful examination, could find but little soreness or other enidence of organic disease. He had a good appetite, and felt pretty well generally. From these data, I gave the patient encouragement that he would recover his health in a short time. He went on well until the 27th of the same month, when, suddenly, he was taken worse than ever--urine retained; some throbbing pain in region of prostate gland, and pain in the back; and a slight febrile movement generally, together with great nervousness. These symptoms were relieved, and recurred again and again until the 20th of October, when I told him the full extent of the mischief, according to my view of the case, and that he could not be cured for at least three months, and, perhaps, a longer time. This was such poor consolation to him that he concluded to dispense with my services and seek aid elsewhere. On the 11th of October, I was again summoned to see Mr. II. Found him unable to pass urine; laborious breathing; a black, dry tongue; pulse very frequent, small, and weak; entire loss of appetite; and unable to raise up in bed. At this time, I told him I would not take charge of the case unless he would allow counsel. This was readily assented to, and I sent for E. Andrews, M.D., of Chicago, who promptly responded, verified the diagnosis, and we agreed upon a course of treatment; but he gradually run down, and died on the 11th of November. The reason I report this case is, that such cases are very infrequent in my practice, and the absence or obscurity of prominent symptoms, leading one to fully appreciate the im- portance of the case he has to deal with at first; the great dif- ficulty in curing them when they are known; and the great lack of authority on the subject, within the reach of the country pr ctitioner. The treatment, I understand to be astringent injections into the bladder, the best of which is nit. silver, in weak solution at first, and increased in strength as it can be tolerated; and the alkalies, buchu, parcira brava, tr. ferri chlo- ridi, potassa brom., and other remedies of this class, by the mouth; rest, and care that the bowels are kept in a soluble condition. May I express the wish, that some member of the profession, of large experience in this class of diseases, will write a mono- graph upon them.

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is 0 0 K dl 0 t I f t 5 Proceedings of the American Pharmaceutical Association at the Fourteenth Annual Meeting, held in Detroit, Mich., August, 1866. Also the Constitution and Roll of Members, Phila- delphia: Merrihew & Son, Printers. 1866. This is a very neatly printed volume of 316 pages, containing the reports, essays, and proceedings presented at the last An- nual Meeting. We should think it a work of great value to every intelligent druggist and pharmaceutist, and several of the reports and papers are equally interesting and valuable to the physician. We think copies can be obtained by applying to E. II. Sargent, Druggist, corner of Randolph and State Streets, Chicago. Diphtheria; A Prize Essay. By E. S. Gaillard, M.D., Rich- mond, Va. Reprinted from the Richmond Medical Journal. This is a monograph of 114 pages. Of the many essays written upon this subject during the last ten years, this is cer- tainly one of the best. The author devotes a large part of his work to the elucidation of the pathology of the disease. He regards the disease as a general one, involving a morbid condi- tion of the whole mass of blood, and the development of certain local inflammations of an asthenic character. Of necessity, treatment founded on such views of the pathology, must be cor- rective and tonic. The correctness of this has been shown by observation at the bedside. On the Relations which Electricity sustains to the Causes of Disease. By S. Littell, M.D., Emeritus Surgeon of Will's Hospital, Philadelphia. From the Transactions of the Amer- ican Medical Association. This is a report of 54 pages, originally presented to the American Medical Association, in Boston, 1865, but not printed in the Transactions until the following year, ft is an exceed- ingly interesting and important paper. We have only space for the following summary of doctrines which are appended to the report:-- "1st. That heat and electricity are identical, as the one can be converted into the other. 2d. That a large volume of electricity surrounds every pri- mary constituent of matter, especially that form of matter which constitutes the gaseous bodies. 13d. That animal heat is supported by the electricity liber- ated from the primary constituents of matter during the pro- cesses of respiration, digestion, and assimilation. 4th. That electricity is evolved during these processes on the same principle as that which is evolved during the action of a galvanic arrangement. 5th. That electricity and nervous power are analogous, if not identical, as the action of one can be successfully substituted for the other. 6th. That the majority of diseases are caused either by the sudden obstruction, or slow abduction of electricity from the body. 7th. That a low state of electric tension on the surface of the earth, produced either by the operation of evaporation, or some occult movement in the great internal currents of the earth is the remote cause of epidemic and pestilential diseases. 8th. That occasional and ordinary diseases are produced by the sudden abstraction or slow subduction of electricity from the body, or its sudden elimination during the vital processes. 9th. That since electricity is so essential to the integrity of the vital operations, it is indispensable that measures be taken to produce its evolution, and to prevent over-radiation. 10th. That electricity is the source of vitality in vegetable life. / 11th. That electricity is attracted by the fibres of the roots of plants; and by the instrumentality of the electric fluid does the plant attract its constituents from the soil. 12th. That vegetables of rapid growth require a large supply of electricity to secure their perfection and completion ; and the potato is a plant of this kind. 13th. That the disease in the potato was produced by the want of nutrition. 14th. That the want of nutrition ar.ose from defective elec- tric agency. 15th. That the cause of the deficiency of this agency was those abstracting influences which produced low tenison of electricity." Reduction of Inverted Uteri, by a New Method. By Tiiomas Addis Emmet, M.D., Surgeon in charge of New York State Women's Hospital. This is a very neatly printed pamphlet of 15 pages, detailing two qases of reduction of inverted uteri by upward pressure, * simultaneous with efforts to dilate the constricting part around the part of the organ last inverted. The first case had existed seven months, and the time consumed in effecting a reduction was three hours and fifty-five minutes, the patient being fully under the anaesthetic influence of ether all the time. The second case was one of eight months duration, and was reduced in one hour and twenty minutes. These cases, as related by Dr. Emmet, are of great interest and value, and should be read in detail by Clinical Observations on Functional Nervous Disorders. By C. Handfield Jones, M.B., Cantab.; F.R.C.P., London; F.R.S.; Physician to St. Mary's Hospital. Philadelphia: Henry C. Lea. 1867. pp. 348. For sale by W. B. Keen & Co., 148 Lake Street. Infantile Paralysis, and the Attendant Deformities. By Chas. Fayette Taylor, M.D., etc., etc., etc. Philadelphia: J. B. Ltppincott & Co. 1867. pp. 119. Duodecimo. For sale by S. C. Griggs & Co., 41 Lake Street. Notes on Epidemics. For the Use of the Public. By Francis Edmund Anstie, M.D., F.R.C.P., Senior-Assistant Physi- cian to the Westminster Hospital. First American Edition. Philadelphia: J. B. Lippincott & Co. 1866. pp. 95. Duo- decimo. For sale by S. C. Griggs & Co., 41 Lake Street. The Common Nature of Epidemics, and their Relations to Cli- mate and Civilization. Also Remarks on Contagion and Quarantine. From Writings and Official Reports. By Southwood Smith, M.D., Physician to the London Fever Hospital, etc., etc., etc. Edited by T. Baker, Esq. Phil- adelphia: J. B. Lippincott & Co. 1866. pp. 130. For sale by S. C. Griggs & Co., 41 Lake St. Price $1.50. Lessons upon the Diagnosis and Treatment of Surgical Dis- eases, Delivered in the month of August, 1865. By Profes- sor Velpeau, Membre de l'lnstitute et de l'Acad&nie de' Mddecine. Collected and edited by A. Regnard, Interne des Hdpitaux. Reviewed by the Professor. Translated by W. C. B. Fifield, M.D. Boston: James Campbell. 1866. Duodecimo, pp. 103. Price $1.00

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ARTICLE XI. v/ PELVIC ABSCESS. By MORTON M. EATON, M.D., of Peoria, Ill. This article is written more as a caution to the use of pes- saries in the treatment of prolapsus uteri, than with any hope of offering anything new on the treatment of "Pelvic Ab- scess," which, I believe, is well established. I may remark, however, that such cases are not very desirable, as the investi- gation and treatment of the case must be very embarrassing to both physician and patient, especially if the patient is a fine lady in the first w'alks of life, and you are called to take charge of the case after a good physician has been dismissed. I will now relate a case which has been of interest to me from its rarity, I never having had but one case of the kind before. Was called to see Mrs. I., of this city, wife of a merchant living on----st., September 5th, 1866. Found that Dr.---, a very fine physician, so called, had been attending and treat- ing her; first for "falling of the womb," in which he had used various hard pessaries, afterwards had treated her for ulcera- tion of the os uteri (the prolapsus not being cured), then again applying the pessaries; the whole time of his treatment having extended over a year or more, nearly ever since the birth of her only child, some 15 months since, had been dismissed, and I was requested to take charge of the case, which I hesitated to do, because I had great respect for the physician that had been employed over a year and dismissed. But assented after urgent solicitation by the patient and her mother, who had been a patient of mine six .years since, while suffering from some female complaint. I consented to examine the case. I found her plethoric, aged 24 years,'the mother of one child; now confined to her bed, where she had already been for over two weeks, complaining of severe pain in the pelvis, and in the hypogastric region. Pulse 110, skin dry, tongue with a white coat; defecation produced severe pain, and the erect posture could not be endured; micturition painful and desire frequent; abdomen tender. On attempting to make a digital examination per vaginum, I found all the parts so sensitive and so much in- flamed and swollen I desisted, and contented myself with knowing that all the organs within the pelvis were highly inflamed, and that I had reason to fear the formation of a pelvic abscess. I ordered fomentations of hops over the external genetalia and hypogastric region, and gave opii. pulv. gr. ss., et hydrarg. chlo. mit. gr. j., every three hours. Sept. 7. Discontinued the mercurial and continued the opiate, and on examination finding considerable swelling on one side of the anus, I changed the hops for a poultice of flax-seed meal, being now well satisfied an abscess had formed, and hoping to have it open externally in its most depending situation. But the swelling lessened the next two days under the application of the poultice, I thought possibly I would not have an abscess; but on making a digital examination per vaginum, which the subsiding of the inflammation permitted, I detected a large fluc- tuating tumor to the right side of the vagina and posteriorly to the same. I then used vaginal injections of warm water, hoping the abscess would open into the vagina, but I was disappointed; for on the next day, Sept. 12th, it opened into the rectum, and discharged profusely. I now gave the elix. of the valerianate of ammonia as an anodyne, and discontinued the opiate, and ordered an enema of warm water and soap twice a-day. Tried a compress in the vagina to press the sides of the abscess to- gether and cause union, and prevent the accumulation of matter, but it could not be retained. The os uteri was very tender and very low in the pelvis. Applied an elastic abdominal sup- porter to the abdomen to press the bowels up, and take off the pressure of the bowels from the uterus, and used no treatment for about two weeks, except the supporter, the valerian to quiet the nerves, and gave potass iodid, 3 gr. doses, with syr. sarsapa- rilla three times a-day. At this time, Sept. 26th, she could sit up without suffering any bearing down pain, but on rising, a pouch was formed beside the rectum, and it being fluctuating, I was certain it contained matter, and feared faecal matter besides. I accordingly opened the tumor with a sharp pointed bistoury, and considerable pus escaped, but nothing of a faecal character. 1 now washed out the cavity with soft tepid water, and injected solu. iodine :--Iodine gr. v., potass iodid. gr. xij, aqua SSj, once a-day, enjoining rest and a farinaceous diet for a week; when I directed her to sit up, and she found* she could do so by using a soft pillow to sit upon. She still wore the abdominal sup- porter, and declared herself feeling better than she had for a year. I gave her elix. bark et ferri protox in SSj doses, and used the iodine 10 gr. to the oj of water once in two or three days. The discharge constantly grew less and less, until Nov. 2d, when it ceased; Nov. 10th, patient discharged cured. By the constant use of the abdominal supporter, the uterus had regained its natural position without any direct treatment, (so called); although I claim that the taking off of the weight of the abdominal viscera from the uterus is the most philosophical treatment in some cases, and I believe this was one. Nov. 20th, saw Mrs. I. at my office, who requested an examination of the uterus to know that those ulcerations were cured. Agree- able to her request, I examined her with a bladed speculum, and found the os uteri perfectly healthy, and all the parts, so far as I could learn, were healthy also. I told her she was "all right," needed no treatment, but to wear the abdominal supporter. Jan. 1st, I learned from Mrs. I. that she was still perfectly well, and had experienced no pain or trouble of any kind for a long time. Now this patient had not been recently confined, or ex- posed to those causes which ordinarily produce this complaint; it is true that authorities state that these abscesses sometimes form without any known cause. But, whatever may have been the cause, in this case I am certain she was treated by authority for the prolapsus, etc. But I do feel disposed to discourage that too commop practice with some of finding ulceration and using caustics; and prolapsus and using pessaries and causing ulcerations, mayhap; and it may be proper to state here, (though I never said anything of the kind to the patient), that I think these things might produce abscess. I have cured some seven or eight cases of procidentia and prolapsus by the use of the abdominal supporter alone, during the past year. It is safe. It is comfortable for the patient, and is liable to do no injury, that I am aware of; it certainly cannot produce "pelvic abscess." One fact in this case was as favorable as remarkable, that no faecal matter found its way into the abscess through the fistula in ano, which existed. In most cases of this kind, I believe it would be advisable, (if the patient would consent), to open the abscess through the vagina, which might prevent its pointing in the rectum, where usually it is very difficult to heal. This might also have prevented the necessity, which afterwards arose, of opening it externally.

PMC9999898

THE MEDICAL USE OF ELECTRICITY. By G. M. BEARD, M.D. and A. D. ROCKWELL, M.D., New York. The history of the medical employment of electricity has been marked by many and peculiar disappointments. It was very natural to infer that an agent at once so mighty and mysterious in its phenomena, should have a great power for good or evil over the human constitution. Hence we find, that after the researches of Galvani had abundantly established the doctrine of the existence of animal electricity, very many en- thusiastic observers set themselves to the task of demonstrating the medicinal virtues of this subtle fluid. Their experiments were attended with a measure of success. Aldini, in 1795; Hufeland, in 1798; Alibert, in 1817 ; and Dr. Mansford, in 1818, clearly establish the fact of the remedial powers of static electricity in certain forms of paralysis and epilepsy. The dis- covery of the induction current by the great Faraday, in 1831, gave a new impetus to the scientific investigations in this de- partment. Matteucci, Du Bois Reymond, Golding Bird, Duch- enne, Remak, and more recently, Brown-S^quard, Rosenthal, Meyer, Benedict, and Ziemssen, have all labored diligently in the field of physiological and medical electricity, and have brought many and valuable sheaves with them. By these investigators, the remedial, as well as the physio- logical, effects of electrization have been repeatedly demon- strated. They have proved that, not only in paralysis and epilepsy, but also in cases of debility and impaired nerve en- ergy, electricity is an agent of vast and wondrous power. And yet, outside of the ranks of these original explorers, there are comparatively few in the profession who have given the subject sufficient heed even to inform themselves as to the diseases fqr which galvanization or faradization are specially applicable. This apathy of the medical world with regard to the success of experiments that promise so much and so surely for the depart- ment of therapeutics, is to be accounted for by a variety of reasons. First of all, electricity, in the various methods in which it is employed, has not fulfilled the general expectation. It has been found to fail utterly in many cases where theoreti- cally it should have achieved the most absolute success; and hence many, disappointed and perhaps disheartened, have illog- ically concluded that their expectations were not w'ell grounded. Again, in our country at least, the practical application of this agent has fallen into the hands of uneducated and unscru- pulous practitioners, who know little of the human system, or of the science of medicine, and Still less of the agent they employ. Emipirics and charlatans, versed in no art except that of rob- bing the unfortunate, have thus far had the field mostly to themselves, and havp improved their advantage by filling their own pockets without adding an iota to the world's stock of ex- perience. Whatever valuable truths they may have stumbled upon by their abundant observations are known only to them- selves, and are regarded by them merely as tricks of trade, and in the very nature of things must die with them. Electricity appears to be travelling slowly in the footsteps of all our per- manent specialities. Twenty years ago, the treatment of the diseases of women was almost exclusively in the hands of ig- norant and unprincipled outsiders; gynecology is now one of the most honored and useful departments of science. It is but fifteen years since oculists were linked with contempt in the speech of all who desired to be regarded as authority in medi- cal etiquette; to call oneself a specialist for the eye was a plea of guilty to the grossest ignorance and fraud. Ten years ago, the diseased throats and ears of the country were at the mercy of a crowd of the most rapacious sharpers that ever amassed fortunes out of human suffering and credu- lity; ten years hence, laryngoscopists and aurists will stand on the same platform with oculists and gynecologists. It is the duty, and it should be the delight, of scientific men, to wrest the medical employment of electricity from the hands of these selfish harpies, and accord to it that honor to which its merits justly entitle it. At the present time medical prac- titioners of all grades are not unwilling to recommend electric- ity in certain cases of paralysis, that will neither yield to inter- nal medication nor get well in spite of it; but they usually allow their patients to use some kind of apparatus at home, or else content themselves with two or three imperfect applications under their own eyes. The results in such cases are almost al- ways unsatisfactory. It could not, indeed, be otherwise. In this way, more than in any other, electricity has been wounded in the homes of its friends. To one case that is cured or relieved by such slipshod procedures, ten are either made worse, or else so little benefitted that they cast their batteries aside, and ever afterwards declare that electricity is a humbug. The truth is, that there is no more sense or reason in allowing patients to make then' own applications of the electric current, than there would be in intrusting them with the responsibility of cutting their own veins, or operating on their own ears and eyes. In three important particulars we arc apt to mistake the employ- ment of electricity. 1. By neglecting to make just discrimina- tion in regard to the types and phases of disease that are found # to yield most readily and surely to this method of treatment. 2. By intrusting the details of the applications to the patients themselves, or some of their non-professional attendants. 3. By not making the applications with sufficient thoroughness and persistence. Our attention having been called to this subject for some time past, we have found that the range of diseases amenable to this form of treatment is much wider than we had ever supposed. We have found that faradization, or the use of the secondary current, is especially indicated in cases of indigestion in all its /myriad shapes; in nervous derangements, when they take the form of chorea, epilepsy, neuralgia, or hypochondriasis; and in general debility and anaemia, dependent on any cause except pulmonary tuberculosis. In our experiments thus far we have made use of Smee's battery, as manufactured by Kidder, of this city, and we have employed in most cases orrly the sec- ondary current. It is very far from being a fixed fact of medical science that the primary current is capable of succeed- ing when the secondary fails; but, if it be used at all, it is nec- essary to obtain the combined strength of a number of ele- ments. The primary current of the battery we use is too weak to be of any special service in ordinary cases, and we have never secured from it any results that could not have been obtained just as surely, and far more rapidly, by faradi- zation, Stohrer's large battery, consisting of twenty-four or thirty-two elements, is a most excellent instrument, and is much employed by Zicmssen, Rosenthal, and other German investi- gators. Thrfce different methods of applying electricity have been recommended by Duchenne; by solid metallic electrodes, me- tallic brushes, and the hand. Of these methods we must prefer the latter. No instrument that human skill shall devise can ever equal the hand in flexibility and power of adaption. If the feet of the patient be placed on a sheet of copper to which the nega- tive pole is attached, the operator, holding the positive pole in one hand, can with the other readily manipulate the parts de- sired t<x.be affected, and by increasing or diminishing his grasp of the sponge, can modify the strength of the application with- out disturbing his apparatus. Used in this way, the current must pass through the body of the operator. The first essays of those who may employ elec- tricity through their own persons, must always be unsatisfac- tory? They will find that they can bear only a very feeble current, or at least one not strong enough to effect any but the weakest patients, or the most sensitive localities. But practice is everything here, as in the use of all other appliances of medicine. According to our observation and experience, the system appears to become accustomed to the powerful elec- tric stream, just as it becomes accustomed to the use of to- bacco, alcohol, opium, hasheesh, or coca; with this difference, that its effects are, if anything, positively beneficial. Dr. Garratt, of Boston, (whose abundant opportunities for observation and varied practical experience in the medical em- ployment of electricity, entitle his views to more consideration than those who have attempted to wade through the verbose and mystic rhetoric of his recent work will be willing to accord to him), advises "that the operator use the same hand that holds the electrode, so as to prevent the passage of so high an induction current through his own person, which is thus to him- self highly injurious and unsafe to be long continued or often repeated." It would be very natural to infer that an agent ,so potent in the cure of disease must be prejudicial to health when used in large excess, for such is found to be the case with nearly all the prominent articles of the materia medica. It is on this probability that Dr. Garratt bases his words of warning; but the facts are against him. Obstinate experience will not wheel into line at the command of any scientific theory, however consistent or plausible. We have now been employing faradization through our own persons for some time, and the effects have thus far been either negative or beneficial. We have both enjoyed our average health since we began to use the agent, and both have observed a marked development of the strength and size of the muscles of the arm. Wm. Mil- ler, of this city, a man of no special medical education, but of the utmost reliability, and thoroughly experienced in the prac- * tical application of the faradaic current, informs us that for the past thirty-five years he has allowed the stream to pass through his own body on an average of about five hours each day. By mathematicial computation, then, it appears that a powerful induced current of electricity has been passing through him for about seven years of his life. Up to the pres- ent time, his general health has been excellent, has, indeed, im- proved under the mighty stimulus, and he has suffered from no disease that can even be remotely ascribed to electricity. It is safe to say that no parallel instance can be found in either hemisphere. Our experience thus far seems to have taught us three im- portant facts:-- 1. Faradization is a tonic of vast and varied powers, and it is chiefly through its tonic effects that it so rapidly and so surely benefits so many chronic asthenic diseases. It almost uniformly relieves chorea, dyspepsia, jaundice, constipation, neuralgia, and chronic rheumatism; also, anaemia, when de- pendent'on functional nervous derangement; and when faith- fully and persistenly employed, it not unfrequently works a permanent cure. Whether these tonic effects of faradization are the result of its mechanical action, or of some subtile nerve power that it mysteriously imparts to the system, or of both combined, we are of course unable to say. Nor is the question a vital one, however interesting it may be to the inquiring spirit of science. The operators of the Atlantic cable inform us that enough electricity can be generated in a vessel no larger than a gun cap, to send' a message from continent to continent, and they are ready to confess that they know as little of the nature of this agent as they did when Morse first planned the line to Washington. Precisely the same principle holds good in the medical em- ployment of electricity. Our ignorance of the rationale of its workings is no bar to our progress in the knowledge of its effects. /# 2. To gain satisfactory results from faradization in long standing cases of debility from whatever cause, the applications must be properly made and thoroughly persisted in. Aftej? the pendulum has been swinging for years in one direction, it does not make the return beat in an instant. In employing electricity, just as in the use of medicaments generally, the time required to complete a cure must bear some proportion to the duration of the malady. 3. For the successful employment of electricity in the var- ious diseases for which it is applicable, there is need of much more skill, patience, and experience than is commonly sup- posed. It cannot be too often repeated, line upon line, and precept upon precept, that no specialty in science, however re- stricted may be its scope, can be thoroughly mastered without a good measure of skill, energy, and patience. And in regard to this very humble department of electricity, in the selection and care of the apparatus, in the wise discrimination between the cases which are and those'which are not amenable to this method of treatment, in the acquiring of the requisite facility and effectiveness of application--in the entire mastering of the whole subject, there is a wide range for the exercise of scientific genius and diligence, and as imperious a necessity for large and varied experience, as in any other department of therapeu- tics.--Medical Record, N. Y.

PMC9999903

O i t or UI. Medical Convention.--At the meeting of the American Medical Association, held in the City of Baltimore, May 3d, 1866, the following resolution was adopted with much unani- mity, and the undersigned appointed a Committee to aid in carrying it into practical effect:-- Ilesolved-, That this Association earnestly requests the Medi- cal Colleges of the country to hold a Convention for the pur- pose of thoroughly revising the present system of Medical Col- lege instruction, and that a Committee be appointed to aid in carrying the resolution into effect. In fulfilling the duties enjoined on them, the undersigned respectfully and earnestly invite the Trustees and Faculty of each of the regularly organized Medical Colleges in the United States to send representatives to a Convention to be held in the City of Cincinnati, Ohio, on Friday preceding the next Annual Meeting of the American Medical Association; namely, on the 3d day of May, 1867. We would also respectfully sug- gest that all delegates to such Convention be prepared to con- sider fully and act upon the following subjects :-- First. The adoption of a more uniform and just rate of Lec- ture Fees by all the Colleges in this country. Second. The propriety of increasing the length of the An- nual Lecture Term, and the number of Professorships. Third. The adoption of measures for securing more thorough attention on the part of students, to the more elementary branches of medical science, and a more progressive order of medical studies. Fourth, The practicability of requiring three Annual Courses of Lectures, instead of two, as a condition of graduation; and of making Hospital Clinical Instruction a necessary part of the Third Course. Fifth. The practicability of establishing and exacting some appropriate standard of preliminary education for young men proposing to enter upon the study of medicine. Feeling confident that a free interchange of views upon these, and such other topics as the Convention miglit deem proper, would result in the adoption of measures of great im- portance to the interests, honor, and usefulness of our profes- sion, we again cordially and earnestly invite your cooperation. N. S. DAVIS, \ S. D. GROSS, WORTHINGTON HOOKER, Committee. M. B. WRIGHT, GEO. C. SHATTUCK, / This is a very important movement, and we sincerely hope that the invitation of the Committee will be responded to by every Medical College in the whole country. The time named, allows three working days before the opening of the next meet- ing of the American Medical Association, during which the im- portant topics connected with the education of the profession could be freely and deliberately considered. It is a movement which has long been demanded by the general sentiment of the profession; and if the older Colleges in Philadelphia, PSIew York, and Boston promptly respond to the invitation of the 116 The Chicago Medical Examiner. [Feb. Committee, the Convention will result in the accomplishment of much good. Illinois State Medical Society.--The next Annual Meet- ing of this Society will be held on the first Tuesday in June, at Springfield. The Committees expected to report at that meet- ing are as follows:-- Committee on Practical Medicine.--Drs. J. Adams Allen, of Chicago; R. E. McVey, of Waverly; and L. T. Hewins, of Loda. On Surgery.--Drs. H. W. Davis, of Paris; C. R. Parke, of Bloomington; and G. R. Bibb, of Jacksonville. On Obstetrics. -- Drs. DeLaskie Miller, of Chicago; N. Wright, of Chatham; J. N. Ralston of Quincy. On Drugs and Medicines.--Drs. P. II. Bailhache, of Spring- field; N. T. Quales, of Chicago; and J. Miner, of Waverly. On Ophthalmology.--Dr. E. L. Holmes, of Chicago. On Spinal Curvatures and Hip-Disease.--Drs. J. W. Freer, and R. G. Bogue, of Chicago. On Plastic Surgery.--Dr. David Prince, of Jacksonville. On the Co-Relation of Electricity and Nervous Force.--Dr., D. T. Kyner, of Macon. On Specialties and Medical Advertising.--Drs. T. D. Fitch and N. S. Davis, of Chicago; and D. Prince, of Jacksonville. On the Radical Cure of Reducible Hernia.--Dr. G. T. Allen, of Springfield. On Syphilis.--Dr. W. M. Chambers, of Charleston. We hope the profession in every part of the State will be represented, for we are sure the meeting will be both interest- ing and profitable. The Volume of Transactions for 1866, has been published and copies sent to all members who are credited with the payment of the annual assessment on the books of the Treasurer. Rush Medical College Commencement.-- The twenty- fourth Annual Commencement of this Institution was held on Wednesday evening, January 30th, 1867; at the end of their usual 16 weeks Lecture Term. Prof. J. V. Z. Blaney, who had been lately elected President of the Faculty, in the place of the late Prof. Brainard, conferred the degree of M.D. on 72 candidates; being about 20 less than the number graduated the year previous. Before conferring the degrees, Prof. Blaney paid an appropriate tribute to the memory of his predecessor, Prof. Brainard. The Valedictory Address was delivered by Prof. E. Ingalls, and consisted mainly, as it should, of plain, practical, common sense instructions to the graduating class. It was officially announced that Prof. Moses Gunn, of De- troit, had received and accepted the appointment to the chair of Surgery, made vacant by the death of Prof. Brainard. Chicago Medical College Commencement.--The Eighth Annual Commencement Exercises of this Institution will take place on Tuesday evening, March 5th, 1867; and will be pre- ceded by a public examination of the candidates in class, dur- ing the preceding day. There is an excellent class in atten- dance, and we have no doubt but its members will sustain themselves creditably, throughout the unusually extended ex- aminations to which they are subjected in this College. Physician's Pocket Record.--We have received, from the office of the Philadelphia Medical and Surgical Reporter, a copy of the Pocket Record, which was noticed and its contents quoted in a recent number of the Examiner. It is published and bound in excellent style, and in its size, arrangement, and con- tents is, perhaps, the most convenient and useful visiting list and memorandum book for the physician that has yet been published. Price $1.50. Books not Received.--We see, by our exchanges, that Dr. I). Prince, of Jacksonville, has published a volume on Ortlio- pcedic Surgery, which is a revision of his report on that subject to the Illinois State Medical Society. Though the publishers have not favored us with a copy, we nevertheless assure our readers that it is one of the best practical works on that sub- ject that has been written, either in this country or in Europe. We also notice, in some of our exchanges, that a newr edition of Wood's Practice of Medicine has been issued, carefully re- vised by its author. Though our recommendation of the work has, probably, aided in its sale throughout the North-west dur- ing the last 15 years, more than any other one individual, yet we were not favored with a copy of the former editions, nor, thus far, one of this. We do not complain of this, for, happily, we are able to buy the new edition, and independent enough to recommend it, as we have done the former ones, so far as we deem it worthy. And if the publishers should send us a dozen copies, we would do nothing more. NOTES UPON GENERAL SCIENCE. Geological Discoveries in tiie Excavation of Chicago Tunnel.--In order to obtain for the City of Chicago a full supply of pure lake water, a tunnel has been dug, commencing at the shore and extending two miles outward, under the bed of Lake Michigan. This excavation is, its whole distance, through the formation called by geologists, "glacial drift," "boulder formation," etc. It is a hard clay, full of boulders, many of which, show, by peculiar marks and parallel scratches on their surfaces, that they have, at some former period, been imbedded in moving glaciers, like those of the Alps. Prof. Agassiz maintains that wherever this drift is found, it has been depos- ited, not by water, but by glaciers. Other geologists dispute this, and claim that the drift was deposited by water, and that the boulders were dropped from icebergs floating on the sur- face. A very important test question in the case was, whether the glacial drift was stratified or not. If stratified, it is a water deposit. If not, it is a glacier deposit. The excavations in the tunnel show that the glacial drift .at this locality is clearly stratified, and, therefore, a water deposit. In excavating, the workmen opened a spring of inflammable gas, which burned four or five days and then ceased. A very curious discovery was made, of numerous "pocke.ts" or masses of clean, loose gravel, bedded in the clay in such forms and singular positions as to show that they were origi- nally masses of frozen gravel, dropped, like boulders, to the bottom, SSind bedded in the accumulating clay, and, finally, thawed out by internal heat after they were covered up in the earth. Death of Major Robert Kennicott.--This distinguished young naturalist went on a scientific expedition to the region near Behring's Straits in connection with the officers of the Overland Telegraph Line, which is to enter Asia by that route. He expected to make very valuable discoveries and collections for tlje Chicago Academy of Sciences He died instantaneously, on the banks of the Youkan River, in the Russian Possessions, probably from apoplexy. His remains are on the -way home. He is lamented as the most active and enthusiastic naturalist of the West, and his death is a great loss to American science. Fossil Remains of the Island of Malta.--Investigations made in the ravines and caverns of Malta, show an astonishing number of elephants, hippopotami, and other large animals, to have lived there at a former age. The appearances indicate that crowds of animals died at once, from some great convul- sion of nature. The geologists who have investigated the de- posits, are of the opinion that more animals died at one time than the whole island could support in its present size. They believe that Malta must, at a former period, have been con- nected with Africa by a tract of territory which is now beneath the sea; and that it became submerged by some convulsion which destroyed the land animals. If this extensive tract were lowest near the present African shore, or began to sink first near there, the effect would be to drive all the animals before the advancing waters until they were concentrated in vast num- bers upon the high grounds of the present island, there to die by starvation, or by the submergence of their last refuge in the waves. The expenditures of the New York State Inebriate Asylum from its organization to September 1, 1866, according to a re- cent report, have been $401,635 29. Mortality for the Month of January.--The subjoined is the mortality report of Health Officer Bridges for the past month. It includes an accurate list of the number of deaths, with places of nativity, cause of death, a comparative state- ment, and other valuable information:-- UATTRFS OF TUP. A TH Accidents,----------------------- 3 Bronchitis,--------------------- 1 Burned,------------------------- 1 Cancer,-------------------------- 2 Childbed,----------------------- 8 Colic,-------------------------- 1 Congestion of Brain,------------ 3 Congestion of Lungs,------------ 2 Consumption,-------------------- 40 Convulsions,--------------------38 Croup,------------------------- 11 Cold,___________________________ 1 Diabetes,----------------------- 1 Disease of Brain,--------------- 1 Disease of Bowels,-------------- 1 Disease of Heart,_______________ 6 Disease of Kidneys,_____________ 4 Disease of Liver,--------------- 2 Disease of Lungs,--------------- 4 Disease of Spine,--------------- 2 Diarrhoea,---------------------- 4 Diphtheria,__________'__________ 8 Delirium Tremens,--------------- 2 Dropsy,_________________________ 5 Erysipelas,_____________________ 2 Epilepsv,----------------------- 1 Fever, Remittent,______________ 3 Fever Purperal,________________ 1 Fever,/Scarlet,_______________ 21 Fever, Spotted,________________ 1 Fever, Typhoid,________________11 Fever, Congestive, ____________ 1 Hydrocephelus,----------------- 3 Inflammation of*Brain,_________ 3 Inflammation of Lungs,_________10 Inflammation of Bowels,________ 3 Inflammation not stated,_______ 3 Killed,________________________ 1 Old Age,____________.__________ 11 Pneumonia, ____________________ 1 Poisoning,_____________________ 1 Phthisis Pulmonalis,___________ 2 Rheumatism,__________________ 1 Stillborn,____________________ 22 Scald________________________ 1 Small-Pox,_____________________ 1 Suicide, ______________________ 2 Teething,_____________________ 12 Whooping-Cough,_______________ 10 Unknown,_______________________20 Total,________________299 Ages of the Deceased.--Under 5 years, 157 ; over 5 and u'nder 10 years> 15; over 10 and under 20, 11; over 20 and under 30, 28; over 30 and under 40, 32; over 4u and under 50, 22; over 50 and under 60, 6; over 60 and under 70, 12; over 70 and under 80, 6; over 80 and under 91', 1; unknown, 9. Total, 299 NATIVITIES. Chicago,___________156 Other States,-------39 Canada,_____________ 5 Denmark,____________ 1 England,----------- 12 Germany,_____________44 Ireland,_____________28 Norway,_____________ 3 Poland,_____________ 1 Scotland, ___________ 4 On the Sea,_________ 1 Unknown,----------- 5 Total,---229 DIVISIONS OF THE CITY. North,..... 93 | South... 87 | West,.......1.19 | Total,. 299 Total number during the month of December,----------------309 Total number last year for the month of January,_________ 292 Metallic Spectacles.--M. Foucault recently communi- cated to the French Academy of Sciences the fact that the sun may be viewed through a lens covered with silver leaf. The sun's disc, shorn of its beams, can thus be clearly seen. Sub- sequently, M. Melscius made a useful application of Foucault's discovery. Having been injured while making an experiment in the laboratory, his eyes were painfully affected by light. In this condition he had recourse to spectacles with black glasses, such as are used by engine-drivers; over these he put green glasses, which answered pretty well; but on further experiment, he found the best method was to use pale-blue goggles, covered with silver or gold film, and these he recommends to all persons troubled with weak eyes. The Headquarters of Drunkenness. -- Liverpool has been pronounced the most drunken town in England. And it is true. Its extreme drunkenness arrests the attention of the judges, its pauperism weighs heavily upon the rate-payers; its rate, fifty-six per thousand, appalling. The drunken cases dealt summarily with by the magistrate are set down at the annual rate of one in thirty-three of the population. The habi- tual drunkards, in their periodic appearances before the bench, form an endless chain of besotted creatures. According to the recently published judicial statistics there are 3,100 habitual drunkards in Liverpool, and they are about equally divided as to sexes.--Liverpool Albion. s------- Poisoned Bread at Winona, Illinois.--It will be remem- bered that in July last, at a hotel in Winona, Illinois, a large number of persons were poisoned by eating warm biscuit at breakfast. The case attracted much attention, from the fact, that a few days before, some forty persons were in a similar manner poisoned at a hotel in Indianapolis; and from the circumstance, that self-raising flour was charged with having produced the poisoning at Winona. The public had not forgot- ten the bread-poisoning on a large scale in the State of N. Y., where the metallic lead used to bind the burr-blooks composing the mill-stones had been abraded and mixed with the flour in grinding. The investigation of the Indianapolis case by Prof. Wormley, of Ohio, revealed in the sour milk employed, with salaeratus, to make the bread light, five and a-half grains of tartar emetic and a trace of arsenic, in a single pint. A similar case at Atlanta, Georgia, in which a whole family was poisoned, was traced to arsenic introduced by a servant. The Winona case was taken up by the physicians and drug- gists of the place, and prosecuted till they and the victims generaly became satisfied that the self-raising flour had nothing to do with the poisoning. The investigation was renewed by Prof. Horsford, of Cambridge, Mass., and the results at which he arrived are embodied in the following statement:-- 1. That there was substantially no self-raising flour in the batch from which the biscuit were made. 2. That poison was introduced into the biscuit, through the sour milk employed with salaeratus, in ordinary flour, to make the biscuit light. 3. That the poison was introduced by design. 4. That the poison was arsenic.--Medical and Surgical Reporter. A Remarkable Solvent.--It is now discovered, it appears, * that if a piece of copper be dissolved in ammonia, a solvent will be obtained, not only for lignine, the most important prin- ciple of all woody fibre -- such as cotton flax, paper, etc.--but also for substances derived from the animal kingdom, such as wool and silk. By the solution of any of these an excellent cement and water-proofer is said to be formed; and, what is equally important, if cotton fabrics be saturated with the solu- tion of wool, they will be enabled to take the dyes -- such as the lac dye and cochineal hitherto suited to woollen goods only. --Exchange. A New Instrument for Subcutaneous Injections.--M. Bouillaud lately presented to the Academy of Medicine of Paris an invention of M. Dancet, consisting of a hollow needle adapted to a metallic tube, ending in a small cup covered with an india-rubber membrane. By slight prq^sure upon the latter the fluid is injected into the areolar tissue, and a simple ( mechanism within the cup allows of the counting of the drops injected. Another and simpler needle on the same principle may be used for vaccination.--Buffalo Med. and Sug. Journal. White Paste.--Make the following mixture, which will ad- here to any substance:--Sugar of lead and alum, each 720 grs.; both are dissolved in water. Take 2| ounces of gum arabic, and dissolved in two quarts of warm water. Mix in a dish 1 pound of wheat flour with the gum water cold, till pasty incon- sistence. Put the dish on the fire, and pour into it the mixture of alum and sugar of lead. Shake well, and take it off the fife when it shows signs of ebullition. Let the whole cool, and the paste is made. If the paste is too thick, add to it some gum water, till in proper consistence.--Journal of Applied Chem- istry. Cholera and Quarantine.--The British Medical Journal says, that it is the intention of the Egyptian government to institute precautionary measures against the importation of cholera by the Mohammedan pilgrims next year. The quaran- tine measures which it has been proposed should be adopted, have been framed with regard to both vessels and caravans, and are to the following effect:--All vessels with pilgrims are to be subjected to interrogation, and if found to have had cholera on board, are to be sent to perform quarantine. All caravans are likewise, if necessary, to undergo quarantine, for which special accommodation is proposed to be provided. And should cholera break out in the Hedjaz, it is proposed that no com- munication between that province and Egypt should be allowed by sea.--Philadelphia Med. and Surg. Reporter. The Gain in the Average Duration of Human Life.-- Dr. C. A. Logan, in his "Report on the Sanitary Relations of the State of Kansas," cites the example of Geneva, in Switzer- land, where an accurate record of the population, births, and deaths, has been kept for more than three centuries past, or since the year 1560. By a series of historical and statistical compila- tions, M. Mallet has ascertained that from the year 1560 to the year 1600, the mean duration of the lives of the people was, in round numbers, twenty-one years and two months. During the seventeenth century, the mean life had increased to twenty- five years and nine months; and in 1833, it had reached forty- five years and five months, being nearly double what it was about two centuries before. This result was brought about by a most salutary regulation of the public health, through which much of the former unnecessary sickness was prevented. The Paris Exposition.--"The improvements in Hospital construction and equipment, in surgical appliances, in means of transportation of sick and wounded, etc., resulting from the vast experience of the War, are considered worthy of exhibi- tion as an evidence of National progress, and with this view, models of U. S. General Hospitals, with their equipment, of ambulances, litters, medicine wagons, etc., have been prepared, and will be forwarded through the proper channels as the con- tribution of the Medical Department U. S. A., to the Paris Exposition." International Medical Congress of Paris.--An Inter- national Medical Congress is to be held in Paris on the 16th of August, 1867, under the auspices of his Excellency the Minis- ter of Public Instruction. The Congress will be exclusively scientific, and will last two weeks. The labors of the Congress will include communications upon questions proposed by the committee, and also upon subjects not in their programme, which runs as follows:--1. The Anatomy and Pathological Physiology of Tubercle--On Tuberculization in different Coun- tries, and its influence on the General Mortality. 2. The gen- eral Accidents which cause Death after Surgical Operations. 3. Is it possible to propose to the various Governments effica- cious measures for restraining the Propagation of Venereal Diseases,? 4. On the influence of the Dietary of different Countries in the Production of given Diseases. 5. On the in- fluence of Climate, Race, and different Conditions of Life on Menstruation in various Countries. 6. On Acclimatization of European Races in Tropical Countries. 7. On the Entozoa and EntophyteS which may be developed in Man. Those who desire to bring forward communications on these or any other subjects, are requested to address their manu- scripts to the General Secretary at least three week (July 26th) before the opening of thb Congress. With a view of limiting and defining the questions in the pro- gramme, the committee has appended to each article commen- taries, which we cannot now quote, but to which we shall subse- quently refer, indicating the points to which it desires that papers should be especially directed. Foreigners may become members of the Congress by addressing a communication to Dr. Jaccoud, Secretaire General, Rue Drouot 4, d Paris.--Lon- don Lancet. The idea of this Convention is an excellent one, and steps have been taken in Boston to secure a representative from members of the Massachusetts Medical Society residing within the Suffolk District.--Boston Medical and Surgical Journal. Eustachian Tube normally closed except in Degluti- tion.--Dr- James Jago, in a communication on the Functions of the Tympanum, published in the British and Foreign Med- ico-Chirurgical Revierc, defends with much plausibility the view which he had propounded before, in an Essay on the Eusta- chian Tube, that the normal condition of this passage is that of closure, except during the act of deglutition. This opinion is based on experiments in his own person, aided by an acciden- tal condition of the fauces, arising from contraction of the tis- sues -on the right side, following amputation of a portion of the uvula. His paper is a very interesting one, and his arguments are most convincing. With regard to the provision for opening the tubes on occasion, he says:-- "That it is not the egress of sonorous vibrations from the tympanum which is to be feared, that being a matter of indif- ference. "But there must be a provision against the ingress of aerial undulations from the throat, which, if admitted, would threaten the membrana tympani with incessant oscillations, and endanger both its integrity and that of the complex and deli- cate apparatus in connection, and violate the peace of the laby- c rinth via this sudden route with all the sonorous impulses im- pressed upon the animal's breath. "That, therefore, the moment seized for bringing the tym- panum into communication with the fauces must be one in which there can be no respiratory current. "That the only instant compelling a suspension of respira- tion is that in which the act of Swallowing is performed, and must therefore be embraced for the service just named. "Finally, the same rule secures the tympanum against the introduction of gastric gases, etc., evolved through the fauces." --Ibid. Prof. Unger, the eminent Viennese botanist and palaeontolo- gist, has been recently examining the bricks used by the an- cient Egyptians in the construction of the Pyramids, and more particularly those of the Pyramid of Dashour. He has dis- covered that the mud of -which they were made contained not only a quantity of animal and vegetable matter, but also frag- ments of many manufactured substances, leading to the conclu- sion that Egypt enjoned a high degree of civilization upward of 5000 years ago. Insufflation of Medicated Powders in Gleet.--Dr. Mal- lez has contrived an instrument by which medicated powders can be conveyed to the membranous portion of the urethra, a region where lies the cause of the gleet, and which region ordinary injections cannot reach. The instrument is chiefly composed of a catheter opened at both ends, another which glides into it, and an apparatus for receiving and projecting the powders. M. Ricord presented the instrument to the Academy of Medicine of Paris, and cases are mentioned in which excellent results were obtained by insufflating subnitrate of bismuth. If is plain that, by previous micturition, the pow- der may remain hours in the passage; and it is thought that the vagina, uterus, or any fistuluous tract may be reached in the same way.--Lancet. * Rapidity of Nerve Action.--Haller attempted in reading the AHneid aloud, to count the number of letters he could pro- nounce in a minute. Finding that he could pronounce 1,500, among which the R, according to his statement, requires ten successive contractions of the stylo-glossus, he affirms that a muscle can contract and relax itself 15,000 times in a minute; .and as the time of relaxation is as long as that of contraction, each contraction requires about 1-30,000 of a minute, or 1-500 of ft second. From this, Haller concludes that the nervous agent requires the 1-500 of a second to go from the brain to the stylo-glossus muscle.--Revue des Cours Sclent.

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THE CHICAGO MEDICAL EXAMINER. N. S. DAVIS, MD, Editor. VOL. VIII. FEBRUARY, 1867. NO. 2. (OnnUal ARTICLE VIII. A NEW APPARATUS FOR MAKING EXTENSION AT THE ANKLE-JOINT. By JULIEN S..SHERMAN, M.D., Chicago. While we have very efficient means for making extension at the hip and knee, and the results of such treatment have been so successful, the ankle-joint has not received the attention, in this direction, that its diseases demand. It is as necessary to remove pressure from an inflamed ankle as from an inflamed hip or knee-joint. The application is, however, more difficult, and, for that reason, has not been used as frequently as desira- ble. Dr. Sayre, some time since, devised an instrument for this purpose, in which both the extension and counter-extension were made by adhesive straps. These are liable to become torn and detached, requiring frequent renewal, especially those upon which the counter-extending force is brought to bear. At the same time, the patient is required, in most instances, to use crutches. The annexed cut represents an apparatus which I have lately been using, and have found most satisfactory in every respect. The counter-extension is made by means of a leather socket, upon the same principle that I represented for the knee-joint, in the January No. of the Examiner. In order to construct it properly, a cast of the patient's leg, from the knee to the ankle, should be taken in plaster of Paris. It is not necessary to include the foot. A piece of sole leather should then be soaked in water, until perfectly soft and pliable, and then moulded and firmly tied upon the cast. It should remain in this condition until thoroughly dry, when it will be .found to form a strong socket, exactly, corresponding to the shape of the leg from which the cast was taken. A steel sole is then cut, the shape of the bo'ft'om of the foot, being some- what narrower beneath the. instep, and heel. From this, and riveted to its under surface, rises, on either side, a steel rod, bent to the shape of the limb; upon its upper two-thirds a screw is cut. This rod is received into a tube, which is attached to the socket. The screw carries a nut, by which the extension is regulated. The rod is braced to the sole by an additional strip of steel on either side. The socket is lined with buckskin and provided with eyelets and lacers. Padding is not neces- sary, as it corresponds so accurately to the limb that the pres- sure is easily tolerated. A layer of sponge rubber is placed upon the sole, which gives an elastic surface to strap the foot upon, and one which will notpacA: or become hard, as is the case with most substances used for this purpose. The apparatus is applied by first adjusting and lacing the socket; the rods are next inserted in the tubes, and the steel sole brought up against the bottom of the foot; adhesive straps, an inch in width and sufficiently long to pass around the foot and heel, are next applied, so as to bind them firmly down to the sole; extension is then made, by turning the nuts upon the rods. By this means, all pressure upon the inflamed surfaces will be overcome, and the deformity of "talipes equinus," so frequent in diseases of this joint, prevented, and the best possi- ble condition for recovery obtained. In walking, the patient bears all his weight in the socket, relieving entirely the ankle- joint.

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ARTICLE IX. CURE OF A CONFIRMED OPIUM-EATER.--RECORD OF THE SYMPTOMS. By E. ANDREWS, M.D., Professor of Surgery in Chicago Medical College. I do not remember to have seen anywhere an accurate record of the symptoms which follow when an opium-eater breaks off suddenly from his pernicious indulgence. I am induced, therefore, to present the following case from my practice, believing that it will be instructive to the profes- sion :-- R. G------, aged about 35 years, of good general habits and character, sent for me to his house, and informed me that he was addicted to the use of opium, and desired to break off the habit. He stated that the appetite was acquired from the long-continued prescription of anodynes by his physician, some two years ago, during a painful sickness. Since then his tolerance had gradually increased, until his present allowance was ten grains of sulphate of morphia a-day, which he took in two doses. lie informed me that he had no love for it, and had got past deriving any pleasure from its use; his daily allowance merely serving to keep him out of an intense but vague feeling of wretchedness, which seized upon him when he attempted to go without his doses. His countenance presented a slightly haggard and nervous aspect, but otherwise there was no appearance of physical or mental deterioration. He was very apprehensive, as most opium-eaters are, that total absti- nence from his drug would kill him. I assured him that he would be very miserable for a few days, but that he would not die. I accordingly directed him to stop at once, and took his word of honor, to use no opiate unless I ordered it;. I promised to watch him closely, and that if he incurred any danger of dying I could easily prevent that by giving some small doses of morphine, at the proper time. I further told him that he might as well die as be an opium-eater. I then removed all opiates from his house, and prescribed some pills of quinine, cannabis indica and hyoscyamus to occupy the attention of his nervous system. The following is the history of the subsequent days:-- 1st Day.--Found him feeble, restless, very weak, and unable to get out of bed. Ilad no sleep, terribly restless, at times delirous, but though more generally rational. Has severe pains occasionally in the sternum, and the lower part of the spine, but the chief distress is an intolerable, undefinable "misery." His pulse is 95, and very soft and weak. His determination to persevere holds out well. Has frequent vomiting and some diarrhoea. The pills seem to be totally powerless to ease him. Gave a few inhalations of ether without any increase of com- fort; potations of whiskey or brandy are vomited up. Every effort to find a substitute for the opiate seems almost a total failure. Oyster soup for nourishment. 2d Day.--Mind slightly wandering in the morning, but rational the rest of the day. Vomits occasionally, and has slight diarrhoea. Pulse 68, and stronger. Milk punch with wine and crust coffee for nourishment. Cannot retain solid food. No medicine. 3d Day.--Mind wandering again in the morning. Pulse 66, but very feeble. Countenance shrunk. Some vomiting and diarrhoea. Feeling uneasy lest his prostration should go too far, I gave him three small doses of laudanum combined with hyoscyamus and cannabis indica. He revived so rapidly and decisively that I was satisfied that he was in no danger, and forbade any more to be given. Beef-tea with wine and crust coffee. Jpth Day.--Morning. Slept five hours for the first time. Rational; no vomiting nor purging. Unable to sit up yet. Tincture of cinchona, hyoscyamus, and cannabis indica. Afternoon. More prostrate. Hitherto his courage has kept up, and he has not asked for morphine. Now he is broken down and begs for it. Gave one small dose which exhilirated him surprisingly, forbade any more. 5 th Day.--No vomiting, but an exhausting diarrhoea. Tried to check it with astringents, terebinthinates, etc., without suc- cess. Was obliged to add a little opium, which accomplished the purpose and greatly revived him. 6th Day.--Diarrhoea worse again; checked it with pills con- taining large doses of nitrate of silver, and small doses of opium. Appetite improves. 7th Day.--Diarrhoea returned and was checked again by the same pills. Feels better; sits up in bed. 8th Day.--Improving. No medicine. 9th Day.--Improving, dressed, and lying on a sofa. Tinct- ure of nux vomica as a tonic. 11th Day.--Doing finely; the nux vomica has produced a great increase of muscular tone, eats well. No diarrhoea. Stop- ped the medicine. 13th Day.--Improving. Walks about the house a little. No medicine. 15th Day.--Doing finely. Has no desire for opium, feels perfectly comfortable, though weak. The tongue, which the first few days had a dense white fur, is now clean. Advised him on no account to take any opiate, nor to prop up his debility by substituting alcoholic drinks, lest he merely ex- change one bad habit for another, but to recover the balance of his strength by the vigor of his own constitution. Discharged from treatment, apparently cured of his appetite.

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* ARTICLE XII. To the Editor of tiie Chicago Medical Exa^miner :-- Sir:--I wish to call your attention, and through the pages of your excellent Journal, that also of the profession generally, to a little work lately issued from the press of J. B. Lippincott & Co., Philadelphia, and entitled "Infantile Paralysis, and its attendant Deformities." The increasing frequency of this malady in this country, es- pecially among the more active and intelligent portion of the community, and the meagreness of literature on this really important subject is, it would seem, a sufficient reason why every physician should welcome the appearance of this really practical, and, therefore, valuable little treatise. It is the pro- duction of Dr. Charles F. Taylor, of New York City, who is well known to the profession as an earnest and successful worker in the department of orthopaedic surgery, and whose wide experience in the treatment of this class of cases has eminently qualified him for his task. This monograph is characterized by the same originality of thought and sound common sense which have distinguished the previous literary efforts of this writer. The ideas therein pre- sented are not to be looked upon as the idle speculations of the theorist, but may be safely accepted as facts which have been established upon the firm foundation of extensive and prolonged observation, and which may be verified by any physician in whose practice cases of infantile paralysis may occur. After defining the term "Infantile Paralysis," and briefly glancing at its causes, the increasing frequency of its occur- rence, its pathology and symptomatology, and mentioning some of the peculiar characteristics of this form of paralysis, the author passes on to the treatment, the consideration of which occupies the larger portion of the work. Considerable space is devoted to the examination of the mechanical causes of the various distortions, which are likely to, and, indeed, almost always do, occur during the progress of this malady, but which the writer clearly demonstrates to be entirely preventable. The facts and arguments contained in the pages of this inter- esting and original little book are finally summed up in the following propositions, viz.:-- " 1. Infantile paralysis is an arrest of vegetative develop- ment from some unknown cause. "2. The characteristics of this form of paralysis suggest a peripheric blight rather than a loss of central nerve power. "3. With diminished nutrition, temperature, and muscular power, there is also diminished muscular irritability; and there is no such thing as involuntary or reflex contraction in infan- tile paralysis. "4. The shortening of certain muscles, is not a necessary consequence of infantile paralysis; and when it does occur, it is simply the adaptation of their length to the position they happen to be in. " 5. It is entirely accidental which muscles.become shortened, whether flexors or extensors. "6. Hence, deformities are not a necessary consequence of infantile paralysis, and when they are allowed to occur, the process of recovery is arrested. "7. When deformities have already formed, they should be treated for an ultimate end, viz.: to bring the patient back to the place from which he should not have bec-n allowed to diverge, where the treatment for hisshould begin. "8. Hence, tenotomy and mechanical appliances are only means to an end -- the first steps of a course of treatment hav- ing in view the restoration of the muscular power. "9. The most natural means for this purpose is the supply of local heat -- involving increased local circulation -- together with local exercise, corresponding with the position and ability of the part exercised. "10. The element of time must also be taken into consider- ation." The foregoing views are elucidated by the relation of some eight or ten cases, the histories of which arc well given, and fully illustrate the points which the writer makes. Not the least interesting feature of the work is to be found in the beautiful wood-cuts which adorn its pages, giving the reader a very clear idea of the distortions usually following the accession of this form of paralysis, and also completely illus- trating that form of treatment which the author has found to be followed by the best results in these cases. E.

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Selections. REPORT ON THE ETIOLOGICAL AND PATHOLOGI- CAL RELATIONS OF EPIDEMIC ERYSIPELAS, SPOTTED FEVER, AND DIPHTHERIA. By N. S. DAVIS, M.D., Prof, of Principles and Practice of Medicine and of Clinical Medicine, in Chicago Medical College. [From the Transactions of the American Medical Association.] There is no department of medical study environed with greater difficulties than that of etiology. And especially is this true of the etiology of such diseases as are styled epidemic. They appear at uncertain, and often remote, intervals; in sec- tions of country widely diverse in relation to geological forma- tion, climate, season, etc.: attack large numbers in quick suc- cession; and then disappear almost as rapidly as they were developed. The elements and agents, mental and physical, pon- derable and imponderable, that are continuously surrounding and capable of impressing an influence upon every living human being, are so numerous and capable of such varied combinations that the problems presented for solution in the study of the causes of disease are among the most complex and obscure that can engage our attention. To solve these problems successfully requires a complete record of the electrical, barometrical, ther- mometrical, hygrometrical, and ozonic conditions of the atmos- phere for a series of years; the position and composition of the soil; the quality of the water; the individual and social habits of the people in relation to dress, diet, drinks, structure of houses, and habits of thought, in direct connection with a faith- ful account of the kind, amount, and specific character of all the diseases that may occur, whether they are epidemic or not. At present, so far as relates to our country, these records do not exist, except to a very limited extent, and hence the data essential for determining with accuracy the causes of any par- ticular epidemic do not exist. To commence systematically, the work of patient and faithful observation and record of facts in relation to all the topics just named, is one of the most im- portant steps that can be taken for the further promotion of medical science. It is easy to assume the existence of some special and subtle poison as the cause of any given epidemic form of disease, and almost equally easy to enter upon exten- sive and plausible speculations in relation to its effects. While to demonstrate the existence or non-existence of such a poison in connection with the prevalence of any given disea'se may re- quire the patient and persistent use of all the means!furnished by modern science, through a series of years. It is not sur- prising, therefore, that our literature should be filled with an almost endless amount of speculation in regard to fever, cholera, and blood or zymotic poisons, until the intelligent student can hardly fail to be reminded of the concoctions, fermentations, and humors of a more remote period in the history of medical science. It may not be proper to claim that every specific morbific agent or poison should be positively identified and its properties determined before its existence can be logically ad- mitted; because certain effects may be found to follow so uni- formly the coexistence of certain circumstances, that the de- velopment of an active agent, capable of producing certain appreciable effects, may be a fair and legitimate conclusion de- duced from the premises. But if we would reduce the uncer- tainties of medical science, lessen the number of yague, intan- gible and contradictory generalizations in medical literature, and substitute therefor real advancement in medical science and art, we must begin by patiently recording observed facts instead of opinions,' and rigid inductive conclusions instead of mere assumptions. And if that section of the American Medical Association, having charge of the subjects of meteorology, medical topography, and epidemic diseases, could devise and carry into effect a successful plan for accomplishing this change so far as relates to those departments of medical science, it would constitute a more important step for the advancement of etiology and hygiene than has been taken during the past half century. It is certain, however, that so long as mere opinions are al- lowed to supply the place of facts, and every writer or teacher is permitted to assume the existence of any specific poison that he can make subservient to his theories, our literature will con- tinue to be filled with the most discordant opinions and the most vague and diverse theories. We shall continue, as heretofore, to amuse and bewilder ourselves with speculations as contrary to the uniformity of nature's laws, as they are to the acknowledged rules of inductive philosophy. One of the most prolific sources of error in our profession consists in partial or incomplete in- vestigations, and the record of only a part of the facts relating to any given subject. This becomes speedily apparent to every one who institutes a serious inquiry after the cause or causes of any particular form of disease. He will find abundant an- nouncements that the disease made its appearance in a given community at such a time; attacked such a number, chiefly of such a class; continued more or less severe for such a time; and disappeared. Not unfrequently these general statements are accompanied by equally general allusions to some one promi- nent sanitary, hygienic, or meteorological circumstance occur- ring coincidently with the disease. But how few are the instances, in the whole range of our voluminous literature, in which the account of any single epidemic prevalence of disease is accompanied by so full a statement of the preceding and ac- companying topographical, meteorological, and hygienic con- ditions, including the special personal hygienie, physical and mental, of those attacked, that we can form a full and reliable idea of the influences that were brought to bear upon the prop- erties and functions of living beings. And yet, without this \ completeness of facts, all etiological deductions must be more liable to be erroneous than truthful.. It is probable that a care- ful review of the history of epidemic diseases would show them capable of being arranged etiologically into two classes. The first class embraces all such as arise directly from a specific virus or animal poison capable of being reproduced in the living animal body, and capable of being propagated in any climate, at any season of the year, and without regard to public or individual hygienic conditions. These, however much they may be influenced in their severity and fatality by collateral circumstances, are universally admitted to depend essentially upon a class of specific poisons, and hence are indisputably contagious. 1 The second class embraces such diseases as appear in an epi- demic form only at irregular intervals; prevail only for a limited period of time; and at any given-prevalence, appear incapable of propagation beyond certain geographical limits or sanitary influences. To this class belong influenza, spetted- fever, erysipelas, diphtheria, cholera, etc. The fact that these diseases have appeared successively or at different times in almost every part of the world; at every season of the year; and among widely different classes of people, has caused their essential causes to be involved in great obscurity, and to become the theme of almost endless specula- tions and controversies. That they are not like endemics, dependent on causes originating in any particular soil or geolog- ical formation, is fully apparent from their occurence in locali- ties so*widely diverse in this respect. The most popular theory is, that a part, at least, of the dis- eases enumerated in this'class arise essentially from some infec- tious poison originating from some primary focus, and spreading from there, chiefly through the atmosphere, but capable of transportation, also, in the holds of ships, in boxes of goods, etc., to the most distant parts of the civilized world. Ilenco, the common expressions applied to them are, they are coming, going, or traveling. While it is generally acknowledged that local sanitary conditions exert a controlling influence over the extent and severity of any one or all of this class of diseases, yet it is claimed that they are incapable of originating them. The popular idea, however, that a pestilential poison, too subtle for identification and scrutiny, can originate at some focal point, and from thence extend from place to place around the globe, will scarcely bear the test of a rigid investigation. All the laws of chemical or physical science indicate that for the pro- duction of any inorganic body, whether solid, fluid, or gaseous, the elements entering into its composition and the circum- stances under which they unite, are uniform. Again, all that has yet been ascertained in regard to the development of vege- table fungi or sporules and animalculae, indicates that each species of these minute organizations requires fixed local con- ditions for their development, and a very limited meteorological and geographical range in which they are capable of self- propagation. To find a species of animalcule generated on the banks- of the Ganges and propagating itself on the snows of Northern Russia, would be as much an anomaly in nature as to find the lion of tropical Africa flourishing in the arctic regions of North America. It is very generally alleged that each of the diseases in the class unde/consideration is identically the same wherever it occurs, and hence there must be an identity or specific char- acter to the cause. If we grant this position, it simply necessi- tates the assumption of another, namely, that the production and propagation of an identical specific cause necessitates the presence of certain uniform materials and circumstances out of which that cause can be evolved. When we find a disease lim- ited in its prevalence to certain geographical and geological boundaries, we naturally look to the soil as the essential source from which the cause of such disease is capable of being pro- duced ; because the composition and conditions of the soil are the uniform circumstances peculiar to the localities,in question. So too, when we find a disease identical in its character prevail- ing on many different geological formations, in various climates, and at different seasons of the year, the same rules of induction would require us to. look for the origin of its cause in some ma- terials and circumstances that are common to all the localities in which the disease itself prevails. And if we find man him- self and the conditions of social life the only conditions uni- formly present, logically we must look to these as furnishing both the materials and the conditions for evolving the imme- diate cause of the disease. There is no reason why diseases o'f a specific character and epidemic prevalence may not be engen- dered by disturbance of vital properties either with or without retention of certain excrementitious materials, as well as by the introduction of special poisons or miasms from without. In- deed, there are so many points of striking contrast between the first class of epidemics known to arise directly from the intro- duction of an animal poison capable of reproduction and propa- gation in the living body, and those constituting the second class, as to afford strong evidence of the entire dissimilarity of their causes. f Each individual disease of the first class has its definite pe- #riod of incubation after the reception of the poison; an equally definite period af irritative fever before the local inflammations of eruptions are established; with an almost uniform period of progress, maturity, and decline of such local manifestations, thus making each case a fixed order of events, each occupying a self-limited time, and always accompanied by the evolution or reproduction of more or less of the same specific poison that had induced the disease. It is liardly necessary to add. that no such order of events, definite as to time and duration, has been observed in influenza, cholera, diphtheria, erysipelas, or spotted-fever; and certainly no evidence of any uniform evolution of a specific poison dur- ing their progress. If, under some circumstances, the secre- tions and emanations from the bodies of patients sick with any one of these diseases, have appeared to be capable of communi- cating the disease directly to others, they have constituted rare exceptions to the general rule. All the diseases of the first class are self-protective, except in very rare instances, occurring only once in the same individ- ual. While the reverse is true of all those belonging to the second class. Again, the diseases of the first class never relapse. Those of the second often. There is still another point of difference having an important bearing upon the etiology of the diseases under consideration. It is, that all the diseases of the second class have their analo- gous or typical forms, among the ordinary sporadic diseases of each returning season. Thus, influenza has its type in the se- verer cases of coryza or acute catarrh; cholera, in the cholera- morbus of every returning summer; diphtheria, in follicular and erythematic inflammations of the fauces; and erysipelas, in the sporadic and traumatic cases of common occurrence. Inasmuch as all these diseases in their sporadic forms or types are everywhere acknowledged to arise from strictly local meteorological and sanitary conditions, and equally conceded that in their epidemic foriris they are greatly influenced both in numerical prevalence and fatality, by the same causes, would it not be more philosophical as well as more in consonance with observed facts, to attribute the epidemic form of any one of them to a simple exaggeration or modification of the same causes that give rise to sporadic cases, without calling to our aid imaginary poisons, and assuming for them powers of diffu- sion contrary to all the known laws of organic or inorganic matter. > f These general observations have been pursued much farther than was originally intended; but they seemed necessary as an introduction to the views I wished to present in relation to the special causes of erysipelas, spotted-fever or cerebro-spinal meningitis, and diphtheria. With the exception of influenza and cholera, no diseases have prevailed more extensively as epidemics than the three just named. They arc almost univer- sally regarded by the profession as b'lood diseases, or, in other words, as dependent upon primary morbid conditions of the blood, inducing secondary local inflammations in various parts of the body. A careful study of the phenomena and results of these diseases, has led me to doubt whether the morbid condi- tions of the blood are really primary and dependent on the introduction into it of some specific poisons from without, or whether they are the effects of a prior disturbance or perversion of those vital affinities by which the primary steps in the pro- cesses of disintegration and secretion are performed, thereby leading cither to the evolution of some morbid product to be returned into the blood, or the failure to evolve some natural product which by its absence would no less certainly leave that fluid in a morbid condition. That the blood presents an unnat- ural or diseased condition while the system is affected by either of the diseases under consideration none will deny. But whether such change in the blood constitutes the primary or essential pathological condition on which all the subsequent phenomena and results of the disease depend, or are only a result of prior changes in the properties and functions of the organized structures is a question of more than merely specula- tive importance. Ever since the prominence given to patho- logical anatomy by the French school of which Louis, Ciiomel, Andral, etc., were such noble ornaments, there has been a manifest tendency to confound morbid anatomy or the effects of disease with true pathology. The investigations necessary to enable me to give a positive answer io the questions just stated, have not yet been completed. But thus far, they have led me to believe that the essential causes of erysipelas are such as are capable of directly depressing and, to some extent, per- verting the elementary vital affinities of the tissues, in such a direction as to disturb the processes of disintegration and to diminish the excretion of alkaline salts. This induces, speed- ily, an excessively alkaline condition of the blood coincident with the accumulation of the products of a disturbed tissue metamorphosis or disintegration. The circumstances capable of producing these primary pathological changes are various, but chiefly involve alterations in the electrical and ozonic con- ditions of the atmosphere, often rendered more efficient by an excess of carbonic acid gas and aqueous vapor. Every practi- cal suigeon is familiar with the fact, that if he places ah undue number of wounded patients in a confined atmosphere, their wounds speedily assume an unhealthy condition, leading di- rectly to erysipelas or gangrene; while if the same patients are left in the open air, sheltered only by tents, no such effects fol- low. Now it can readily be demonstrated that such confine- ment of the air with an accumulation of exhaled carbonic acid gas and, aqueous vapor is capable of changing its ozonic and electrical conditions, even in a few hours. It is^also generally conceded that these atmospheric constituents are capable of undergoing sudden and important changes over extensive dis- tricts of country, regardless of geological formations or paral- lels of latitude; thus affording an adequate explanation of the occurrence of the disease in localities so various, and with such variable degrees of severity. This view of the essential pathol- ogy and causation of erysipelas is corroborated by the well- known fact that the habitual use of drinks which, like alcohol, retard the natural tissue changes, decidedly predispose to at- tacks of erysipelas or, in other words, favor the development of the erysipelatous diathesis. The conclusion at which I have arrived in regard to the dis- ease promiscuously styled "spotted fever" and "cerebro-spinal meningitis," is, that as reported in our literature, no less than three or four distinct diseases have been confounded together. Th,e firsi class of cases, embracing those most extensively prevalent as well-marked epidemics, and tending most rapidly to fatal results, were no more nor less than true erysipelas, in which the cerebro-spinal nervous structures with their enveloping membranes, constituted the seat of the local inflammatory de- velopments instead of the fauces or cutaneous surfaces. This view is sustained by the immediate preceding or coincident prevalence of well-marked cutaneous erysipelas, which has been noticed by most of the later writers on this subject; by the rapid progress of the disease; by the almost uniform aplastic character of the local exudations and changes; and by the fact of cases in which manifest erysipelas of the fauces and face has been accompanied by all the pathognomonic symptoms |Of fatal cerebro-spinal meningitis. One case of this kind occurred under my own observation only a few months since. In a re- cent paper on the cerebro-spinal meningitis that prevailed so severely and extensively in the middle and western states be*- tween 1844 and 1848, read to the Illinois State Medical Society, Dr. J. Adams Allen, formerly in the medical department of University of Michigan, says: "Erysipelas is the most frequent and dangerous of complications. It is easily kindled upon the slightest abrasion of the surface, and often, without such a nidus, attacks the face and neck, extending to the scalp, or more rarely seizing the extremities." Dr. J. S. Jewell, bf the Chicago Medical College, in a letter presented to the same society, speaks of witnessing'an epidemic both of "spotted fever or cerebro-spinal meningitis" and of "erysipelas" in the same localities in the southern part of Ill- inois during the years 1862-3. Close examination of another class of cases will show them to be either modified forms of typhus or of scarlatina. While still another class, much fewer in number, and generally occurring sporadically, are simple acute inflammations of the membranes enveloping the cerebro- spinal axis and base of the b^ain. In regard to diphtheria, I will only add to the observations already made, the opinion that its causative influences are an- alagous to, though not identical with, those of erysipelas. That while they induce such modifications of vital affinity in the tissues generally as to greatly lessen their tonicity, and such disturbances of the atomic or cell changes of tissue metamor- phosis as to cause a morbid condition of the effete elements of the blood, they also produce a well marked tendency to aplas- tic albuminous exudations, as shown by the rapid formation of aplastic deposits on all inflamed or abraded surfaces and the elimination of albumen through the kidneys. These changes in the properties of the elementary structures and in the nitro- genous elements of the blood would necessarily devclope great debility with so much spanemia or blood impoverishment, as to afford a rational explanation of such well-known and peculiar sequelae of this disease, as unusual muscular debility, protract- ed convalesence, and frequent paralysis, either partial or com- plete. I have thus compressed, into less than a dozen pages of manuscript, an outline of those views of the etiology and path- ology of qrysipelas, spotted fever, and diphtheria which would require the compass of a volume to illustrate the facts, which might be adduced for the purpose of testing their claim to cre- dibility. My sole object in presenting them, is to elicit discus- sion and excite more rigid and extensive investigations. o O

PMC9999911

Mercy Hospital Clinic:--Cardiac Disease with (Edema of the Lung, etc.--Inflammation of Knee-Joint.--Clinic by Prof. N. S. Davis.-- Ward No. 9. The attention of the class was first called to Mr. B., a German, aged about 24 years. The lecturer reminded the members of the class that they had already once carefully examined the same patient, immediately after his admission to the hospital, eight days previously. At that time, the patient was sitting up in bed, the knees drawn up and the arms resting on them for the purpose of supporting the body in a position a little inclined forward, with extreme dyspnoea. The face was somewhat bloated; expression dull, with constant drowsiness; and the lips, nose, and hands were of a livid or dark purplish color, and colder than natural. The pulse was quick, small, and irregular, and the heart's action irregular, but tumultuous and violent. The tongue was clean; the mouth moist; bowels regular; urine natural though scanty; but loss of appetite and great sense of weakness. Percussion revealed entire dullness over the lower part of the right side. Auscultation afforded no respiratory sound over the whole left side, and only a coarse rhonchus over the upper and anterior part of the right. From the extreme difficulty of breathing and the irregular and violent action of the heart, it was almost impossible to appreciate the cardiac sounds. All that could be learned concerning the history of the case was, that he had been troubled with frequent paroxysms of dyspnoea, called asthma, for two or three years, and a constantly increasing shortness of breath on attempting to take exercise. In analyzing the symptoms and physical signs, at that time, with a view to diagnosis, it was stated that the dyspnoea, the dullness on percussion, and the absence of respiratory murmur, all indicated greatly increased density of the lungs and a cor- responding diminution of capacity for air. And it was stated that such increased density might depend on three different pathological conditions, namely, pneumonic hepatization, com- pression from pleuritic effusion, and oedema or serous infiltra- tion of the pulmonary tissue. That it was not the first, in the case before us, was evident from the absence of fever, of pneu- monic expectoration, and of those rhonchi which are always present in some degree in hepatization, and from the attitude of the patient. We never see a patient with hepatization of the lung sufficiently extensive to render a whole side dull on percussion, and face livid from decarbonization of the blood, habitually seeking, to sit upright in bed with the arms resting on the knees, as was the case with this patient. That it was not pleuritic effusion, was equally evident, from the absence of enlargement of the side most affected, the absence of any bulg- ing of the intercostal spaces, and the absence of displacement of the heart; for if the left side of the chest was filled with serous .effusion sufficient to suppress the respiratory murmur and rendei' the whole side dull, it would necessarily enlarge the side and crowd the heart towards the sternum. The class will remember that by this negative process of in- vestigation, as well as by the positive character of the existing symptoms, it was announced as the opinion of the lecturer, that the patient was laboring under extensive oedema of the left lung, with partial oedema of the lower lobe of the right. Whether this state of the lungs had resulted from primary valvular disease of the heart, more especially of the mitral valve, which would obstruct the return of blood from the lungs, or from such a degree of constriction of the bronchial tubes as had prevented sufficient ingress of air to oxygenate and decar- bonize the blood, could not be positively determined at that time for reasons already given. The immediate indicatibns for / treatment, however, were obvious. The pati'ent was suffering the direct effects of defective aeration of the blood, while the h^art was violently sending the blood to the already engorged and infiltrated lungs faster than it is capable of passing through the pulmonary capillaries. Hence, to increase the oxygenation of the blood, and moderate the violent and unsteady action of the heart, were indications of pressing importance. To accom- plish the first, the patient was ordered to have the following:-- Chlorate of Potass.,----_---------------- 5ij- Pulv. G. Arabic,-------------------------5iij. Mix and dissolve in an ordinary tumbler full of cold water, and take a tablespoonful every two hours, until the blueness of the lips, nose, and hands was diminished, and then lengthen the intervals to once in four hours. To meet the second indi- cation, three drops of the saturated tincture of veratrum viride were directed to be taken between each of the doses of the chlorate of potassa, and the quantity increased or diminished as should be found necessary to keep the action of the heart more quiet and uniform. This treatment was continued for three days, with a slow bu$ decided improvement in the condi- tion of the patient. The heart's action became more steady; the pulse more regular; the lips, nose, and hands more natural color; and the dyspnoea less. Six-grain doses of iodide of pot- assa were then given in place of the chlorate, every four hours, and six drops of tinct. gelseminum alternated with it in place of the veratrum viride. This has constituted the treatment until the present time. The patient is now resting in the recumbent position; pulse nearly regular; skin natural in temperature, and much improved in color; but the respiration is still very short and inflation of the lungs very imperfect, with frequent suffocating cough; scanty and tenacious expectoration, and great sense of weariness, yet unable to obtain refreshing sleep. The patient being quiet and resting in an easy position, each member of the class was required again to listen to the cardiac and respiratory sounds. The heart now acting more slowly and regularly than at the first examination, it was easy to dis- tinguish a rough sound continuous after the first sound of the heart and coincident with the diastole of the ventricles. It was most audible about one inch below the nipple, nearly over the apex of the heart, thus indicating disease of the mitral valve sufficient to partially obstruct the left auriculo-ventricular opening. On extending the examination to the lungs, it was found that the right lung expanded much more freely than at the time the patient was admitted, although there was still some dullness and sub-mucous rhonchus over the lower and posterior part of that side. The upper lobe of the left lung had become partially permeable, as indicated by some rhonchus, but the dullness was still strongly marked. And the sudden, short expiratory act showed that far less than the natural quantity of air entered the lungs by inspiration. The present examination confirmed the previous diagnosis, so far as related to the pulmo- nary oedema, and rendered it quite certain that it was compli- cated with organic valvular disease of the heart. The existence of the latter, rendered the prognosis unfavorable, so far as re- lated to full recovery. And yet, the continuance of judicious treatment may so far improve the condition of the patient as to enable him to take some moderate degree of exercise. The objects to be accomplished by treatment are still the same as were pointed out at the previous clinic, namely, to control the excessive action of the heart; to hasten the reabsorption of the serous effusion or infiltration into the pulmonary tissue; and to promote the rest of the patient. To accomplish these purposes, the patient was directed a simple but nutritious diet; six drops of the saturated tincture of gelseminum half an hour after each meal, and a teaspoonful of the following emulsion every four hours:-- R. Chloroform,--------------------y__l-------5iij. Fl. Ext. Cannabis Ind.,----------------- 5iij. Iodide Potassa,--------------r-_--------Siij. Pulv. G. Arabic,-------------------1 __ White Sugar, .2............. )aa 31v' Rub together, and add, Mint Water,----------------------------- giij. Mix. Case II. The second case presented to the class during the clinic hour, was one in which there had been sub-acute inflam- mation of the synovial membrane and cartilages of the knee- joint; but which had nearly disappeared under the influence of entire rest and a succession of blisters over different parts of the joint. Of this, our space will not admit even a brief report.

PMC9999912

NEW YORK ACADEMY OF MEDICINE. Dr. Post again introduced Dr. Quinby's patient for the pur- pose of showing the progress of the case. He remarked that there cduld here be no arrest to the growth of the leg, since no portion of the tibia or fibula had been removed, and that, as a result of this operation, the patient was not prevented from wearing a boot. The patient then exhibited his control over his movements by walking in different gaits, jumping, etc. Continuation of the Discussion on Chronic Metritis. Dr. Kammerer remarked that the discussion of chroniclme- tritis had gone back to the very premises--to wit: whether there was such a disease as chronic metritis or not. lie thought that the cause of this variance lay in the fact that pathological anatomy had outstripped clinical observation. lie would ask, in considering this topic, whether or not this de- rangement in nutrition was marked by exudation, a stagnation of the circulation, etc. Hyperaemia was no symptom, since the sexual organs suffered a recurrence of that condition every four weeks. Irritation should certainly not be confounded with inflammation; and regarding Virchow's explanation of the phenomena of inflammation as decidely the best, he found none willing to claim that the conditions as laid down by that emi- nent authority were here present. That they were met with in perimetritis with pelvic peritonitis, and in endometritis, he had no doubt; but as far as the body was concerned, he should be more reserved in his opinion. French authors have no doubts of the existence of metritis. Prof. Klob, of Vienna, whose work, published in 1863, has not yet been translated, who made 1000 autopsies in the General Hospitals, failed to find a single case of genuine metritis. All the changes pointed only to hy- persemia. Entertaining these views, backed as they were by authority so eminent, lie could only regard the term chronic me- tritis, as a misnomer. The subjective symptoms of chronic me- tritis, then, if we may allow the term as a matter of conven- ience, so far as our clinical observation goes, are derangements of the functions, amenorrhoea, dysmenorrhoea, sterility, etc, while the objective are an enlarged organ, with ulcerations, abrasions, and discolorations. We may very readly make out the size by what is technically known as the double touch, i. e. by the use of the sound simultaneously with palpation of the abdomen. The cavity may be found deeper and wider, the or- gan itself enlarged, which latter is, after all, the only pathog- nomonic symptom. He would admit, however, that we must not expect to be invariably fortunate in making out the enlage- ment of the organ, since the thickness of the tegumentary coverings has quite frequently foiled us. He also did not re- gard a tender as neccessarily an inflamed uterus--for a certain amount of hyperaesthesia might be present, without looking towards any very grave disease, since pain of any account would indicate peritonitis or ovaritis. The pathological anato- my of the disease will be found to reveal a morbid condition rather than a morbid process. We may find the muscular fibres hypertrophied and the connective tissue increased in quantity, but even these may constitute merely a quantitative anomaly, and that, too, within the limits of health. The chronic indura- tioirresulting from engorgement was due to an increase of the connective tissue at the expense of the muscular fibres; the or- gan may have an anaemic hue, and may creak under the knife. All this was not inflammation, but merely the result of long- continued congestion or hyperaemia. He might refer to the two forms of hyperaemia as proper to be borne in mind, while considering the case now in dispute. The arterial form is well typified in menstruation and puerperal fever; while venous congestion is exemplified in those instances where obstacles are offered to the reflux of blood, as in dis- placements, flexions, adhesions, and the embedment of fibrous tumors within the walls. lie conceived that the diverse opi- nions formed regarding this condition of things might be ex- plained by the fact that not enough stress had been laid upon such complications as peritonitis or its sequelae of adhesions, latero-versions by the contractions of ligaments, etc. Chronic peritonitis was likewise a frequent complication. The best remedies within our grasp were antiphlogisties and frequent tepid baths. For the accompanying endometritis, the very first condition was to keep the orifice well dilated for the escape of the secretions, by which the mucous membranes arc relieved, and the general condition rendered more comfort- able. Thorough dilatation might be effected through the well known agency of bougies and sea-tangle (laminaria di git ata') or sponge tents. lie desired to call attention to two local reme- dies, which had not yet come into general use. The first of these was pyroligneous acid, first introduced to the profession by Dr. Meyer, of Berlin, and which was held in high esteem, especially by German practitioners. He would assure those disposed to give this agent a trial, that there was no danger in its use, provided the article were pure. The second remedy was carbolic acid in concentrated solution, which might be in- troduced into the cavity by a brush. No bad results have been known to occur; the only obstacle to its application he knew of, was the presence of acute peritoneal irritation oi* sub-acute inflammation. When displacements existed, our only resort was, of course, to adjust them if possible; but all cases of slight hypertrophy he would let alone, unless, perhaps, when the cervix assumed the form of prolapse, he might attack the neck by surgical means, such ashy the ecraseur or by the electro-caustic method. When the hyperaemia was due to a general cause,--to cardiac complications or tuberculosis, but little mitigation of the patient's sufferings need be expected. After all, the only real cure, in his opinion, was effected when senile atrophy ended the woman's parturient history. Dr. Peaslee said: He had hoped to have listened instead of speaking to-night; but some of the topics which had been dis- cussed, he thought required further elucidation. He thought that the view' he had taken at the previous meet- ing, of the subject under consideration, was both logical and scientific, and one which could not be successfully opposed. He had without argument admitted the existence of parenchy- matous inflammation of the uterus; though he was aware that Bernutz and others doubt if acute parenchymatous inflammation of the unimpregnated uterus ever occurs; and Klob, as Dr. Kammerer has told us, admits that he has never, in all his post mortem Examinations, been able to demonstrate parenchymatous metritis in any form. Neither had he (Dr. P.) discussed the nature of inflammation, since that would have led him too far from his main object. Dr. Kammerer has stated that its most important characteristic is an exudation of the plasma of the blood between the histological elements of the part affected, as all must admit in the present state of general pathology. Dr. P. had simply specified the symptoms recognised by all writers as indicative of inflammation of the parenchyma of the uterus, and admitting its existence where they do exist, he had refused to admit it where they do not. But he had shown that these symptoms do not exist,, and have not existed at all, in a large majority of all the cases generally included under the term chronic parenchymatous metritis; while they do appear, and then disappear again to recur, in the minority of these cases. He therefore decided that the majority are not cases of metritis at all, while metritis recurred from time to time in the minority of the cases. On further examination he found the former pre- sented the symptoms of chronic congestion merely, while the latter presented the same state with attacks af metritis super- vening upon it. This view had been somewhat earnestly criticised at the last meeting, as he (Dr. P.) hoped it 'might, since it had been held by'him the last fifteen years, and finds constant confirmation in his practice, and he regretted that Dr. Barker could not be present this evening, since he might wish to reply to criticisms which he (Dr. P.) should in turn feel obliged to make. Alluding to Dr. Barker's division of the cases of chronic me- tritis into three classes, Dr. P. said he (Dr. B.) had committed the too common error of confounding the effects, or sequelae, of inflammation with inflammation itself. Dr. Churchill has adopted the same classification (and added two or three classes more); but he so blends acute and chronic metritis in his ac- count of parenchymatous inflammation of the uterus, that one can get no clear idea of the difference between them on the one hand, or between them and induration, or softening, or suppura- tion on the other. Dr. P. would speak only of the two first classes of cases recognised by Dr. Barker, viz.: (1) chronic me- tritis complicated with indurations; and (2) the same complica- ted with softening. , Twenty-five years ago (said Dr. P.), it was an axiom in gen- eral pathology that chronic inflammation produces induration or hardening, while acute inflammation produces softening. This statement, however, does not present the facts as they really exist, but merely a simple view of them. In the first place, we must remember that the characteristic element of the inflam- matory process isjan exudation of the plasma of the blood from the capillary vessels of the part affected into the intercapillary spaces, and among its histological elements. As this is, of course, itself softer than the tissue proper, the whole mass of tissues and plasma thus become softer than the tissues above in their natural state. An immediate effect, then, of inflamma- tion in all cases (acute or chronic) is softening. But this exu- dation among the tissues may subsequently be disposed of in either of three^entirely distinct ways. It may (1) be entirely and promptly reabsorbed, in which case it is customary to say that the inflammation terminates in resolution; or (2) it may become organized, and thus be permanently blended with the tissues of the part, and in this case the whole mass of tissue and neoplasma, together, will (in the caso of a soft solid) be af- ter a time harder than before, and we say induration has taken place; or (3) the exuded plasma may degenerate into pus, and be thrown out from the part, when we say suppuration has en- sued. The accurate statement of the facts is, therefore, this: inflammation directly produces softening, as the result of its exudation of the blood plasma into the part; and-if hardening ensues after a time in a part where inflammation had existed, it is due to an organisation of the same plasma which at first ren- dered the same part softer. It does not depend on the charac- ter of the inflammation, whether acute or chronic, but merely on the fact of the organization of the plasma, instead of its reabsorption or its degeneration; and this organization requires a certain amount of time. In other words, it is a chronic result of an inflammation, though the latter may have been itself acute or chronic. Metritis, therefore, complicated with softening, is simply actue metritis; for the softening is one of its essential and never absent results. Of course we do not here consider fatty degeneration and other forms of softening of the uterjne tissue, which have no known or suspected relation to the inflammatory process. And chronic metritis, complicated with induration, is simply hardening of the uterus from the organization of the product of a previous inflammation. Congestion is,, however, very liable to continue for a longer or shorter time after the inflammatory process subsides, and hence we often find chronic congestion coexisting with induration. Besides, we may have recurrent inflammations in an indurated uterus; but, if so, this inflam'mation needs no peculiar treatment on account of the in- duration ; and the latter still remains to be treated after the inflammation subsides. The distinction of the two classes re- ferred to, therefore, of complications with chronic parenchyma- tous metritis, are pathologically incorrect, and besides have no therapeutical value. On the other hand, we remember that induration is continually found without any inflammation or even congestion of the part; though sub-involution after par- turtion is sometimes mistaken for it. Another error which Dr. P. had to specify was the confound- ing of engorgement with inflammation in the case of any organ. Some, however, go further than this, and use the terms conges- tion, engorgement, and inflammation, as if they mean precisely the same thing. When we study the phenomena of inflamma- tion artifically produced in the web of the frog's foot, or the wing of the bat, we find that the stimulant which we apply pro- duces, 1st, an increased flow of blood to, and through, the cap- illaries of the part (local determination of blood). 2d, a loss of pcwer of the vessels from over distension, and, therefore, a diminished flow7 of blood through them (congestion); and 3d, an entire stagnation of the blood in the capillaries, and the exuda- tion of its plasma into the inter-capillary spaces, while the cor- puscles remain in the vessels (inflammation.) On the other hand, when recovery takes place, the inflammation first fades into congestion, and this into the healthy condition of the part. The difference, therefore, between inflammation and congestion is distinctly marked, and always demonstrable under the mic- roscope. But the term engorgement simply means that the part is choked up with an extra amount of fluid, either in the vessels or between them, or both. Hence it may in one case mean'mere congestion, and in another, the state produced by inflammation (the vessels distended with blood corpuscles and the plasma exuded from the vessels). But it is never properly applied to the inflammatory process itself. It has, therefore, no scientific value; and the sooner it is entirely dropped from the nomenclature of pathology, the better. Another point to which Dr. P. desired to call attention is the statement, which had of late become quite fashionable, that the body and the cervix of the uterus are distinct organs, which he characterized as entirely incorrect, whether we consider their relations in a developcmntal, a histiological, an anatomical, a physiological, a pathological, or a therapeutical point of view. 1st. Developmentally, the cervix and the body are one and the same organ. The internal female genital organs are devel- oped from the ovaries; each developing one-half of the uterus and one Fallopian tube. The body and cervix are continuous in structure from the first. At birth, however, the cervix is nearly twice as large as the body, constituting about two-thirds of the whole organ ; and the uterus has the form of a cone, with its apex at the fundus. / 2d. Histologically, the body and the cervix uteri are the same also. There arc the same tissues in both, and both are sup- plied with vessels and nerves from the same sources. The ar- rangment of the mucous lining of the cervix is different from that of the body; but the tissue is the same. And besides the mucous membrane, the nerves, bloodvessels, and lymphatics, and the pertioneal investment, there is nothing but collagenous (or connective) tissue and non-striated fibre in either. Dr. Barker has spoken of a similarity of the uterus, in a histological point of view, to cartilage and bone. But cartilage has neither bloodvessels, lymphatics, nerves, nor muscular fibre, nor any other of the tissues found in the uterus. It has only two histological elements, cartilage cells and a hyaline # substance, in which they are imbedded. Bone, on the other hand, has no muscular fibres or collagenous tissue like the uterus; but owes its peculiarities to its phosphate of lime and other salts combined with osteine. Histologically, therefore, the comparison of the uterus with cartilage and bone, is incor- rect. 3d. Anatomically considered, the cervix and the body are but parts of the same organ. It has been stated that the mus- cular fibres of the body of the uterus are nowhere prolonged into the neck except posteriorly. If this were really so, the, cervix would be torn from the body at their junction in front in case of parturition with rigidity of the cervix; and thy child would be expelled into the peritonealy cavity through the rup- ture. But what are the anatomical^ facts? Simply that the longitudinal fibres are prolonged from the body of the uterus into the cervix both anteriorly and posteriorly. Dr. P. publish- ed this statement in his work on histology, ten years ago; and he who dissects the uterus of a woman who dies within a week or two after parturition, can easily verify it. As to the ar- rangement of muscular fibres, there is a striking analogy be- tween the uterine body and neck, and the body and neck of the bladder; and neither of these organs could expel its contents' with the precise arrangement that obtains. 4th. Physiologically, a distinction is to be made between the body and the neck of the uterus; but even here they are to be regarded as one and the same organ. The function of men- struation is performed by the body, and not at all by the cervix, but the Fallopian tubes also participate with the body in that function. Gestation also is accomplished by the body, and very slightly, if at all, by the cervix (for he would not here discuss the question of the obliteration of the cervix by merging into the body in the latter months of pregnancy). The mucus secreted by the cervix differs from that of the body also. But the great culminating function of the body of the uterus is turition, and in this the cervix acts an important part--as a portion of the same organ. Viewed in respect to this function, the cervix is merely the sphincter muscle of the body, as at the end of the rectum we find the sphincter muscle of that canal. The office of both is also the same, viz., to prevent the prema- ture evacuation of the canal which it closes. But a sphincter can never open itself; it must be forced open, as is the case with the sphincter ani, or pulled and forced at the same time, as is the case with the cervix uteri and the neck of the bladder. And the continuation of the longitudinal fibres of the body of the uterus into the cervix, both anteriorly and posteriorly, as has been explained, is the only arrangement .which could ac- complish this double effect on the cervix which has just been mentioned. The cervix and the body of the uterus are, then, not distinct organs. 5th. Nor do we discover the asserted independence of the cervix uteri and the body, when we consider their pathological relations. Endocervicitis may, and often does, exist without extending into the uterine cavity, and becoming endometritis also; and cervicitis occurs independently of metritis proper; though both metritis and endometritis far less frequently occur uncomplicated with cervicitis and endocervicitis. Still, we know that an irritation in the cervical canal by a sponge-tent frequently produces endometritis as well as a miscarriage in case of pregnancy; and that the common cause of metritis proper in newly-married woman is contusion of the cervix. In other words, certain pathological states of the cervix often ex- tend their influence directly to the body of the uterus, as we might expect; and others extend more frequently in the reverse direction: though both these facts are inconsistent with the idea that these parts are distinct organs. 6th. Finally, the cervix and the body of the uterus are not distinct.organs in a therapeutical point of view; and this is a fact of the highest practical importance. If we cannot affect the body of the womb, as has been asserted, by any application to the cervix, of course all local treatment must be abandoned as useless; since applications to any other part must, by parity of reasoning, be even less efficient still. If the abstraction of blood from the cervix doos not modify the circulation of the body of the uterus, when both are supplied by vessels from the same source, he could not imagine how we could affect the uterine circulation by leeching or scarification at any other point. But what are the facts? He had noticed that scarifica- tions, often repeated,' of the cervix, in the cases under discus- sion, produce immediate relief in most cases, and which is fre- quently permanent; and Dr. Barker also has admitted the relief, though he believes it is merely temporary. But any degree of relief shows that the circulation of the body of the uterus is thus modified. Besides, Dr. Barker places his main confidence, so * far as local treatment is concerned, in vaginal injections of warm water--a practice quite irrational if the cervix and body are independent organs; but which also was ' occasionally resorted to by himself, on the principle that the water thus applied to the cervix extends its. effects to the body also. But he (Dr. P.') would not extend his remarks further on the question of the dependence of these two portions of the uterus. Dr. Kammerer had remarked that he knew of no treatment which would remove the induration of the uterus before men- tioned. Dr. P. regretted that he could not shed much light on that point; but he thought we must trust mainly to the bichloride of mercury, bromide of potassium, electro-magne- tism, and especially to time. The meeting then adjourned.

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Proceedins of Socities. ADAMS COUNTY MEDICAL SOCIETY. The regular annual meeting of the Adams County Medical Society assembled at the office of Dr. Robbins, Quincy, May 13, 1867, at 10| o'clock A.M., the President, Dr. J. N. Ralston, in the Chair. Present--Drs. Ralston, Helms, Watson, Wilson, Kendall, Bassett, R. Williams, Baker, Drude, Cadwell, Martin, and Robbins. The minutes of the last regular, and subsequent called meet- ings, were read and approved. The treasurer, Dr. Watson, presented his annual report, which was read and ordered on file. Dr. Kendall moved that the charges against Dr. M. F. Bas- sett be taken up for consideration. Pending which the Presi- dent explained why he had no annual address prepared; and, * on motion of Dr. Drude, the Society adjourned to 2 o'clock P.M. AFTERNOON SESSION. The Society was called to order at 2 o'clock P.M., the Pres- ident, Dr. Ralston, in the Chair. Present--Drs. Ralston, Bane, Watson, Moss, Bassett, Mar- tin, Helms, McNeall, W. J. Brown, C. C. Brown, Wilson, Wil- liams, Drude, Morris, Baker, Kendall, Lunn, Cadwell, and Robbins. The motion to take up the case of Dr. Bassett, pending when the Society adjourned, was carried. Dr. Bassett being called upon, responded that he was ready to proceed with the case, and proceeded to state that the rea- sons given in the circular letter which he had issued to the pro- fession, were those that impelled him to the course he had pur- sued. He had used the remedy there referred to in many cases of carcinomatous disease, and in none without benefit. Serious illness had interfered with his investigations, and it was too early to estimate the true value of the remedy. He had sub- mitted it to a competent chemist, who had succeeded in ascer- taining some of its constituents. These results he would give to the profession, and could he succeed in learning all the con- stituents, he would give it all to them. He had had no con- cealment, and desired none. He plead "not guilty." The circular issued by Dr. Bassett was then read. Dr. Watson moved an acquittal of the charge contained in the first specification, which was carried by the following vote: Ayes--Ealston, Watson, Wilson, Drude, Robbins, Baker, Williams, McNeall, Martin, Moss, Morris. Nayes--Kendall, Helms, Cadwell, Bane. Dr. Robbins moved an acquittal on the second specification. After considerable discussion and further remarks by Dr. Bassett, Dr. Bane offered as a substitute for the motion of Dr. Robbins, the following: Whereas, On the 10th of December, 1866, charges were preferred aginst Dr. M. F. Bassett, of having violated ethical principles contained in chapter ii., sections 3 and 4, of the Code of Medical Ethics of the American Medical Association; and, Whereas, He has this day satisfactorily explained the course on which such charges were predicated, stating that he fully believed himself to be acting within the scope of the code of ethics; therefore Resolved, That said charges and specifications be indefinitely postponed. On motion of Dr. Robbins, the resolution was amended, by striking out the words "indefinitely postponed," and inserting in lieu thereof the word " dismissed." On motion of Dr. Bane, the second clause of the preamble was amended by inserting after the word " ethics," the follow- ing, viz.: "admitting a technical violation of the letter of sec- tion 4 of said code, but not of its spirit." The preamble and resolutions, as amended, was then adopted by the following vote: Ayes--Watson, Wilson, Drude, Robbins, Moss, Williams, Martin, Morris. Nays--Ralston, Kendall, Helms, Cadwell, Bane, Brown, McNeall. Dr. Robbins moved a reconsideration, which motion to recon- sider was, on his own motion, laid on the table. Charles C. Brown, M.D., was proposed for membership by his father, Dr. Wm. J. Brown, and the proposition referred to the Censors, who reported him a regularly qualified physician, in good standing, he having graduated at Rush Medical College, Chicago, his diploma bearing date January 25, 1867. On motion, he was regularly admitted to membership. On the application of Dr. C. R. S. Curtis for membership, the Censors report him a regularly qualified physician, a gradu- ate of the New York Medical College, his diploma bearing date February, 1854. The report was referred back to the Censors, with instruc- tions to confer with Dr. Curtis, relative to some publications in the daily papers, supposed to have been made with his knowl- edge, and consult and report at the next regular meeting. On motion, the regular order of business was suspended, and the Society proceeded to the election of officers for the ensuing year. The following named gentlemen were elected: President--Dr. Louis Watson. Vice-Presidents--Dr. J. W. Bartlett, Dr. M. M. Bane. Recording and Corresponding Secretary--Dr. J. Robbins. Treasurer--Dr. H. W. Kendall. Censors--Dr. J. T. Wilson, Dr. M. F. Bassett, Dr. Richard Williams. Ordered, That the dues of members who have retired from active practice be remitted, and that they be exempt from pay- ing dues until otherwise ordered. Dr. Wilson, one of the essayists for this meeting, reported a paper prepared, but, owing to the lateness of the hour, its hear- ing was postponed until the next regular meeting. Drs. Landon and Roeschlant both being absent, and it being understood that both had papers prepared, their appointment as essayists was continued. Drs. Joseph Robbins, Louis Watson, H. W. Kendall, J. T. Wilson, and Richard Williams, were elected delegates to the Illinois State Medical Society, and it was ordered that each delegate be authorized to appoint his own substitute, in case of inability to attend. Dr. Robbins offered the following resolution, which was adopted: Resolved, That a cordial invitation be, and is, hereby ex- tended to the Illinois State Medical Society, to hold its next annual meeting in the city of Quincy; and we assure its mem- bers of a hearty welcome from their professional brethren in the City of Quincy, and the County of Adams. Adjourned. JOSEPH ROBBINS, M.D., Secretary. Mr. Editor:-- At the Regular Quarterly Meeting of the Adams County Medical Society, held in this city on Monday, the 12th ult., it was ordered that such portion of the proceedings of said meeting as referred to the case of Dr. Bassett, be published in the Chicago medical journals. Under this order I transmit the following: Dr. Bane moved to take from the table the motion to recon- sider the vote by which the resolution referring to the charges against Dr. Bassett, was passed at the Annual Meeting in May. Dr. Robbins raised a question of order. After considerable discussion the President decided the mo- tion of Dr. Bane out of order, but invited an appeal. An appeal was taken by Dr. Bane; the yeas and nays were demanded, and the decision of the Chair reversed by the fol- lowing vote: Ayes--Wilson, Bassett, Robbins, Williams, Bonney, Martin, 6. Nays--Ralston, Stahl, Bartlett, Kendall, Helms, Baker, Shepherd, Cadwell, Hess, Bane, Landon, Young, Leach, 13. The yeas and nays were then taken on the motion to recon- sider, and it was carried: Ayes--Ralston, Stahl, Bartlett, Kendall, Helms, Baker, Shepherd, Cadwell, Hess, Bane, Landon, Young, Leach, 13. Nays--Watson, Wilson, Robbins, Williams, Bonney, Martin, 6. On motion of Dr. Young, the charges against Dr. Bassett were referred to a committee of five, with instructions to report at the Annual Meeting in May next, said committee to be ap- pointed by the Society. The Society appointed Drs. Wilson, Bartlett, Ralston, Rob- bins, and Bane, to that committee. Dr. Ralston moved the suspension of Dr. Bassett from the rights and privileges of membership until the next Annual Meeting. A two-thirds vote being required, the motion was, on taking the yeas and nays, lost by the following vote: Ayes--Ralston, Stahl, Kendall, Helms, Baker, Shepherd, Cadwell, Hess, Bane, Landon, Leach, 11. Nays--Watson, Bartlett, Wilson, Robbins, Young, Wil- liams, 6. A true copy from the records. JOSEPH ROBBINS, Secretary.

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TREATMENT OF DIABETES. By ABBOTS SMITH, M.D., M.R.C.P., &c. Dr. Smith says, in his instructive little work On Diabetes, that the plan of treatment most likely to prove beneficial in this complaint is as follows:--To limit the patient's diet to such articles as do not contain sugar or starch; to attend carefully to the state of the secretions, especially those of the bowels and skin, promoting the action of the former by the administration of podophyllin (so as to act particularly upon the liver), or sa- line purgatives, and increasing the action of the skin by diapho- retics, the hot-air bath, warm clothing (flannel worn next the skin), and moderate exercise. When the general condition of the patient has in this manner been improved, we must specially direct our attention to the morbid secretion of the urine, and endeavor to check it by suitable medicines. To give any par- ticular remedy, simply because it has been known to be benefi- cial in diabetes, before the general points referred to have re- ceived attention, is opposed to common sense as it is likely to result in failure. The following general diet may be adopted by patients suffering from diabetes:-- Breakfast.--Bacon, mutton-chop, or eggs; one of the substi- tutes for ordinary bread; butter; tea, coffee, or cocoa, made with freshly ground nibs, and not with the ground cocoa-powder, as sold in the shops, unsweetned with sugar, and without milk. Dinner.--Beef-tea, broths, or soups not flavored with carrots or other vegetables; mutton or beef, poultry or game, and fish; cabbages, greens; occasionally, but sparingly, rice pudding without milk, blanc-mange made with cream, not with milk; cheese, butter, and bran, gluten, or almond bread. (This meal should not be taken later than three or four P.M.) For desert, the patient may be allowed a glass or tw'o of sherry or claret, and oily nuts, such as hazel-nuts or filberts, or walnuts. All other kinds of fruit must be interdicted. Tea.--Similar to breakfast, with the exception of meat, which is not requisite. Supper (at nine or ten P.M.).--Dietetic bread and butter, with a little meat, or a small basin of rice milk without sugar. In the medical treatment of diabetes, the remedies which are of most frequent benefit are alteratives and tonics, so as to im- prove the appetite and general condition of the patient, and thus enable him the better to bear up against the great drain upon the system, caused by the elimination of the morbid sac- charine materials. Quinine, gentian, and other bitters are very useful for improving the tone of the stomach; and the state of the patient may be still further amended by the administration of cod-liver oil, and of the preparations of iron. No remedy in the Materia Medica is of such value in the treatment of diabetes as cod-liver oil, it has a great tendency to improve the condition of the blood by increasing the proportion of the red corpuscles, which undergo considerable diminution in the blood of diabetic persons.

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ARTICLE XXXIX. EXPERIMENTAL INQUIRIES CONCERNING THE PHYSIOLOGICAL EFFECTS OF ALCOHOLIC DRINKS ON MAN. By N. S. DAVIS, M.D., Professor Practical and Clinical Medicine, Chicago Medical College. Read to the Illinois State Medical Society, June, 1867. To investigate patiently and thoroughly the modus operandi and effects of such agents, as by their general use both by the profession and the community, are exerting important influences on human health, life, and happiness, is one of the most im- perative duties incumbent on the physician. That alcoholic drinks, both fermented and distilled, are so used, and that they are daily exerting an immense influence over human life and happiness is universally acknowledged. Hence we ask your candid and patient attention to the following results of investi- gations concerning their effects on the human system. That alcohol, when drank in the form of beer, wine, whis- ky, or brandy, is rapidly absorbed and carried with the blood into all the structures of the body, has long been known. 1. That while thus present in the blood, even in very mode- rate quantities, it so far retards those atomic and cell changes which constitute nutrition and disintegration, as to diminish the sum total of eliminations from the body, has been fully demon- strated by the experiments of Drs. Prout and Chambers, of England, Boecker, of Germany, Hammond and others in our country. 2. That its presence diminishes and disturbs innervation or nerve force, is pretty clearly established by Chambers, and still more fully by the daily observations of all classes in the community. 3. That the alcohol, when taken into the human system, neither becomes digested nor appropriated as food, nor chemi- cally changed in any way while in the system, but is excreted or eliminated as alcohol, through the lungs, skin, and kidneys, was clearly shown by the experiments of Rudolph Messing, in 1854, and fully confirmed by those of Lallemand, Perrin, and Duroy, in 1860. While the foregoing investigations are sufficient to establish the fact, that alcohol acts simply as a foreign body in the hu- man system, and by its presence retarding the play of vital affinities to such an extent as to materially impair the great functions of tissue change, elimination, and innervation; they left its effects on the circulation and colorification undetermined. To supply this deficiciency I instituted a series of experi- ments in 1850, the results of which were communicated to the American Medical Association, at its meeting in Charleston, in May, 1851, and published in the North-western Medical and Surgical Journal for that year. These experiments showed that the presence of only a few ounces of either fermented or distilled drinks, in the human system was sufficient to produce a positive diminution of temperature. Two years preceding, namely, in 1848, M. M. Dumereil and Dumarquay, in making some experiments on intoxicated dogs, found their temperature uniformly reduced. For the purpose of verifying still further these results, and adding some coincident observations on the circulation, as indicated by the sphygmograph, I instituted, early in April last, two additional experiments, as follows: On the 6th of April, 1867, four hours after dinner, when the functions were supposed to be undisturbed by digestion, and the man in good health, the temperature of his body was carefully noted by a delicately graduated thermometer inserted under the tongue, with the lips closed around it; the rate of the pulse and its qualities, as indicated by the sphygmograph, were re- corded at the same time. Four ounces of bourbon whisky were then administered, diluted with sweetened water. The same observations in regard to temperature and conditions of pulse were made and recorded every half hour, until two full hours had passed. A series of observations, in all respects similar, were made on the 11th of April, except the whisky, for which four ounces of sherry wine were substituted. The results of these two experiments are best shown by the following diagrams, with the notes accompanying them: Experiment No. 1--April 6, 1867. Experiment No. 2--April 77, 1867. It will be seen that under the influence of the whisky the tem- perature diminished f of a degree in one hour; while under the in- fluence of the same quantity of wine it diminished | a degree in the same length of time. Under the influence of whisky the rate of pulsations fluctuated, increasing during the first hour from 83 to 89, and decreasing during the second hour from 89 to 85 per minute. Under the influence of the wine the rate steadily decreased from 78 to 71 or 72. The qualities of the pulse, as indicated by the sphygmograph, are the same in kind, differing only in degree in the two experiments. An inspection of the cuts and accompanying notes will give a much more perfect idea of these representations than any description that can be given in words. It will be seen that each pulse expands the artery to a greater extent and more suddenly than before the alcoholic liquid was taken, and that the commence- ment of the contraction equally more sudden, while the whole line becomes more wavy or irregular; thereby much resembling the pulse lines when the arterial coats are weakened by fatty degeneration; or in such diseases as are accompanied by en- feebled capillary circulation, like typhus and typhoid fevers. Although the inferences to be drawn from the sphygmographic pulse lines as connected with different physiological and patho- logical conditions of the human system are yet imperfectly un- derstood, yet so far as observations have been made, the lines in the accompanying diagram indicate retarded movement of blood in the capillaries, and consequent increased sudden- ness of expansion and contraction of the arterial trunks by the impulse of the heart. If this inference be correct, then we may sum up the results of all the varied and ingenious experi- ments in reference to the effects of alcohol on the human sys- tem, many of which have been performed both in this country and Europe, in the two following propositions: First. Its presence in the blood directly interferes with the normal play of vital affinities and cell action in such a manner as to diminish the rapidity of nutrition and disintegration, and consequently to diminish the dependent functions of elimina- tion, calorification, and innervation; thereby making alcohol a positive organic sedative, instead of a diffusable stimulant, as is popularly supposed both in and out of the profession. Second. That the alcohol itself acts in the system exclusively as a foreign substance incapable of assimilation or decomposi- tion by the vital functions, and is ultimately excreted or elimi- nated without chemical change. The important bearing of these conclusions on the therapeu- tic and hygienic uses of alcoholic drinks, must be obvious to all, and especially demand the careful attention of every mem- ber of our profession.

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DIABETES. The plan Dr. Hare, of University College Hospital, adopts in cases of diabetes, is to allow the patients, when first admitted, the diet of the hospital in as great quantities as they desire. After pursuing this plan for a day or two, he changes to the usual restricted diet for diabetic patients, and can thus ascer- tain for himself the exact difference so produced. ( The effect is quiet amazing. The quantity of urine is diminished, as is the amount of sugar contained in it, and by persevering in this plan of dieting he is able to reduce the specific gravity of the urine to a very low standard. In one case recently under his care it came down to 1007, yet there was a trace of sugar present. Cases have been recorded where sugar was found in urine hav- ing a specific gravity of 1015 or 1016, but we believe that this is one of the, if not the very, lowest densities presented by urine containing sugar. Dr. Hare usually combines his dietetic treat- ment with the exhibition of the tinct. ferri perchloridi and opi- ates night and morning.--Medical Times and Gazette, January 12, 1867.

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THE CHICAGO MEDICAL EXAMINER. N. S. DAVIS, M.D., Editor. VOL. VIII. SEPTEMBER, 1867. NO. 9. Wmtoi oiitHhnm. ARTICLE XXXVII. CEREBRO-SPINAL MENINGITIS. By F. R. PAYNE, M.D., Marshall, Ill. Read to the Clark County Medical Society, July 1st, 1867. This is a disease with which you are all painfully and prac- tically familiar. It has in the last few years prevailed in many parts of our own county. Our observations clearly demonstrate that we have at least two varieties of this fearful malady, simple and malignant. For the purpose of bringing this disease fully before you, we propose to report two cases of the malignant form, which oc- curred in one family during the last month, one of which was examined after death. Case I. May 29th, 1867, 3 o'clock P.M. Dr. R. F. Wil- Williams and I were called to see Miss C., aged 8 years, and and found her laboring under the following symptoms: She was well this morning; ate her breakfast; about 10 or 11 o'clock A.M. she complained of being chilly, and had a severe pain in the back of her head, and in her neck, extending down the spine. The pain in head carefully noted, and did not ex- tend above tentorium; the pulse 160; very small, and the sur- face of the body presented a cyanotic hue; a prickling and tingling sensation in the arms; body very sensitive and hot; eyes suffused; mind excited; speaks loud, quick, and distinct; extremities tremulous; gasping breathing; very restless; co- pious perspiration; tongue whitish, or creamy coat, and moist; tremulous sensation in epigastrium, and, in fact, all of the pre- monitory symptoms of convulsions; evidently irritation or con- gestion of cerrebellum and spine. These were the symptoms three or four hours after the first chilly sensation. 7 o'clock P.M. Nausea and occasionally efforts to vomit; violent delirium; pupils largely and permanently dilated; ex- tremely restless; right side more effected than left; total loss of consciousness; surface cold; no pulse at the wrist; no ac- tion on bowels; rose colored spots, from the size of a pin's head to half an inch and over in diameter; not confluent, and no elevation of the skin; the spots seem to be the broken cor- puscles of blood retained in the capillaries; the whole surface on back and chest blue; the spots are constant in all malignant cases; the cyanotic hue of back chest, lips, and eye-lids, we have found present in all violent cases, and after death this condition is increased. All of the symptoms clearly indicate a point with positive certainty to the cerebellum and spinal cord as the seat of disease; she breathes hard, rather slow, and la- borious; twitching of the muscles of extremities, and rigidity of the extensors of the back and flexors of fingers and fore- arms; trismus, or partial closure of the jaw, and difficult de- glutition. This was a young, healthy girl, very large for her age; full of blood and life twelve hours ago. 11 o'clock P.M. Symptoms about the same; every evidence of approaching dissolution; complete coma; pupils very large, and not sensitive to light; convulsive movements of right arm and leg; cold and clammy perspiration; her medicine had ope- rated finely on the bowels; breathing rather slow and laborious. It is almost impossible for her to swallow water. She lived until about 12 o'clock on the 30th, and then died without a struggle. She lived twenty-four hours after the first inception of the disease. The remedial agents used in this case did not seem to exert the least beneficial or controlling influ- ence. Case II. June 3d, 1867. Another child of the same family, was seized with the same train of symptoms, about 10 o'clock to-day--a boy six years old. When first visited, one or two hours after he complained of being chilly, the symptoms were the same as the first case--if any difference they were more aggravated. 3 o'clock P.M. He is very restless; pupils dilate largely, and then contract; pulse very rapid; skin hot; eyes suffused; tonic spasm of muscles of the superior extremities. 5 o'clock P.M. Surface cold; no pulse at the wrist; pupils largely dilated; cold, clammy perspiration; complete loss of consciousness; in short, nearly the same symptoms as in the first case; the only exception is that about 8 o'clock P.M., this little boy began to halloo and scream terrifically, and continued this until midnight, and then expired. We have had the misfortune to witness many cases of this awful disease, and feel satisfied that there are more than one variety. At least 96 per cent, of the malignant cases (lie. We are also convinced that many cases are called "spotted fever," in which the cerebro-spinal symptoms are purely sympathetic, caused from reflex action. For the purpose of more fully bringing this important sub- ject before the Society, we will present some important facts contained in the able, pointed, and valuable treatises on this disease by Prof. J. S. Jewell. His paper is prepared with great care, and evinces profound research. It is published in the Chicago Medical Examiner for October and November, 1866. Prof. Jewell has consulted nearly all the writers on this disease in Europe and this country, and the weight of testimo- ny is that it is dependent upon a primary specific epidemic cause, the true nature of which is not known, save in its effects. It may not be external, but internal, or autopathic. Many ex- ternal causes, singly and combined, have been assigned to this malady. Social misery, foul air, imperfect nutrition, exposure to cold and damp atmosphere, abuse of alcohol, and a host of others, have been pointed out by able medical men, singly and combined, as not only predisposing, but positive and essential causes. It is known that these external causes do not always produce the disease, it is therefore reasonable to say that it must be assigned to that indefinite and imperfectly understood class of epidemic causes. Our experience accords with Prof. Jewell. No age is ex- empt, but the young are the principal victims. Generally it attacks the young, vigorous, and athletic, and it is a pretty well established fact that males are more liable than females. There is no evidence that a hereditary influence plays any part in the production of this disease as an essential cause. It is a matter of much regret that there has not been more frequent examinations of the blood. It has been positively demonstrated that this disease quickly destroys the nervous, vascular, and secretory functions. The capillary congestion is rapidly fol- lowed by the developement of serous or purulent infliltration wherever local hyperaemia or inflammation exists. This being true, we, feel confident that future investigations will demon- strate a breaking up of the affinities between the blood corpus- cles and organized structures of the body. It is very evident that the cause, whatever it may be, of this terrible malady, has a powerful septic or degenerative tendency. It is supposed by many that the cause of this disease is iden- tical with that of malignant erysipelas in its essential nature. Others think it is a malignant form of scarlatina and typhus. The causes of diptheria and hog cholera are by some supposed to be identical with the cause of this disease. The attack is sudden, and marked; the progress to a fatal termination so rapid; the terrible shock to the nervous system, as shown by the symptoms, all clearly indicate that some powerful poison has been introduced into the system. That the constituents of the blood are changed from their normal condition, is also true, and no external visible primary cause can be assigned for this rapid transition from life to death. We are forced to the be- lief that some potent, uniform, and yet unknown agent produces the disease. Dr. Jewell is of the opinion that it is a disease sui generis, that is essentially different from, and independent of other re- cognized forms of disease. Our observations favor the opinion that the agent that pro- duces "spotted fever" is similar, if not the same, that prima- rally engendered "black tongue," a terrible epidemic that pre- vailed in this county in 1845-46. It is almost universally the opinion of men who have had experience in this affection that it is not contagious. It does not conform to a single law of contagion, but does fully con- form to the laws of epidemic influence. The poison, whatever it may be, frequently acts directly on the nerves, but it is not yet known whether it is the changes in the blood or the direct effects of the poison that gives rise to the symptoms and appearances presented in this disease. The post mortem appearances in the second case above re- ported will be of interest to many. Drs. Gard, Price, Wil- liams and Lodge were present. After removing the cranium we found the diploe of the occipital bone, deeply colored with blood. This was not the case in the other bones through which the saw passed. The dura mater in the back part and base of the brain was in a high state of congestion; in fact, all the meninges in that region of the head and upper part of the spinal cord were in the same condition. The capillaries seemed enlarged and intensely engorged with blood. After being thoroughly soaked in cold water they still presented that red and engorged appearance. The tentorium was also very much engorged; beneath this membrane in cerebellum and around the pous Variola and medulla oblongata we found fully three ounces of a reddish serous exudation. There was not an abnormal amount of fluid in the ventricles. The nervous sub- stance was healthy, and the membranes in the upper part of head and cerebrum were apparently in a normal condition. All the evidence of disease was found in base of brain and cervical portion of the spinal cord. He was a healthy, athletic boy, very large for his age. Before refering to the therapeutic his- tory of this disease we will briefly present some of the patho- logical deductions, and in so doing will consult the able mono- graph of Prof. Jewell. First. The symptoms which refer to the nervous system are always present; but in many cases they are much milder than in the two cases above. Second. The pathological appearances found in the cerebro- spinal cavity are in some degree always present, and in all ma- lignant cases in a marked degree. Third. The monographs of Europe and this country, exam- ined by Prof. Jewell, teach that the blood shows a decided increase of fibrine, and generally of corpuscles. After death the blood is more fluid and dark than customary. Fourth. It is not a form of typhus. It is not contagious, but probably infectious. Sixth. It is caused by a special external epidemic poison. Seventh. This supposed cause acts on the nervous system and blood, and destroys life by its septic or degenerative ten- dency in a few hours. Eighth. The disease or its primary cause may be modified or influenced by malaria or periodical diseases. With our present pathological knowledge, aided by the expe- rience of able men in this country and Europe, what are the best indications for treatment? The physician, when called to a malignant case, and sees the rapidity with which the nervous, vascular, and secretory func- tion are destroyed, the blood looses its organic and vital power by the action of some morbid and energetic poison, which is, if not controlled, bound to quickly divorce soul and body. With our present knowledge of the disease we cannot fail to doubt the power of remedial agents to stop the mischief. The indications for the treatment of this disease are: First. To equalize the circulation, and thus prevent, if pos- sible, local hyperemia, especially of the meningis of cerebellum and spinal cord. Second. To quiet the irritability of the nervous system, and, if possible, introduce into the system some anteseptic which will neutralize or in some way counteract the deleterious effects of the epidemic poison, which is supposed to be the primary cause of the disease. If the local hyperemia is not speedily removed the disten- sion and extreme congestion of the capillaries of the membranes of the cerebellum and spinal cord will, as in the above case, result in effusion, and that within twelve hours. In these cases the plethora is asthenic, and experience does not teach us that blood-letting will recall the lost tone of the over-distended ves- sels. Our experience accords with a great majority of the ob- servers of this disease, both in this country and Europe, tha t blood-letting is inadmissible. Local bleeding may in some cases do good, by cups and leeches along the spine. The physician, when first called to a case, and finds a quic k pulse; eyes suffused, and symptoms of great cerebral excite- ment, and apparently general congestion, is impressed writh t he belief that general blood-letting would be beneficial; but the weight of experience is against its employment. It seems to be pretty generally admitted that this remedy increases the sighing or gasping breathing, which warns us of the rapid fail- ure of the spinal functions, which are so intimately connected with the processes of life. The remedial agents which act as stimulants to the heart a nd vessels, and to the cerebral functions, and at the same tim e operate as sedatives to the medullary system, if energeticall y persevered in at the onset of the disease, offer some hope of equalizing the capillary circulation. These are alcohol, ether, opium, sumbul, chloroform, and many others, are acknowledged as useful and efficient in spasmodic and convulsive affections, when there is no inflammation. They seem to give vigor and equal diffusion to the circula- tion, and thus prevent local determination and congestion o f blood in the nervous centers. In this terrible disease it is ad- visable to assist these agents by the external application of heat and counter-irritation. Dr. Jewell says, after a thorough investigation of the tr e at- ment of this disease, "stimulants have been found useful in a 11 periods of the disease, especially in proportion as they are early employed, both externally and internally." Opium seems to stand at the head of remedial agents, a nd is emphatically and almost unanimously endorsed by those who have witnessed its effects in this disease. If we succeed with our opium, brandy, and external applica- tions in equalizing the circulation, and for the time, relieve the local congestion, if the primary or epidemic cause is not removed or neutralized, we may expect a return of the symptoms in all of their former vigor. This being true, it is certainly impor- tant that we promptly and early use those remedies which ex- perience has pointed out as best calculated to fill the second indication for the treatment of the disease. We have no knowledge of this non-cognizable or zymotic agent save in its effects, consequently the remedies best calcu- lated to remove or neutralize it must be submitted to the test of experiment. It is supposed to be a leaven or ferment, an active septic matter, a very small quantity of which, when in- troduced into living organism, will promote change and decom- position. " A little leaven leaveneth the whole lump." Its action is probably chemical, and breaks up the affinities of com- pound organic principles. If this is true we have a reasonable explanation of the rapid decomposition and change this agent works in the blood. The remedies found most efficient in coun- teracting its effects when in the system, are the arsenites and permanganates; chlorine and charcoal are also highly recom- mended as capable of destroying this class (zomatic) poisons. Their beneficial effects are produced without as well as within the body. Chlorine may be used with great benefit on the floors and walls of infected houses; but its acrid qualities ren- ders it objectionable as an internal remedy. Would it not be well for future investigators to try and de- termine the true nature of this concealed epidemic cause, by frequent analyzation of the blood of those who contract the disease. It is believed by many that epidemic and infectious diseases are caused by the invasion and operation of living parasites, which enter the body and disturb its functions and structures. If it is an animacule,'may they, when introduced into the sys- tem, under certain circumstances, be capable of self-propaga- tion. This idea receives support from the phenomena of itch. This disease infects through the itch-mite, and is known to spread by this animal's propagation. It is a generally admitted fact that cerebro-spinal meningitis prevails in damp or foggy weather. Thus the subtle poison or animalcule seems to require moisture to aid it in its invisible march through space on its mission of death. This is all purely hypothetical, and with our present knowledge is not supported by any trustworthy facts. It is our purpose in this paper to refer to all of the most im- portant remedial agents which have been employed in the treat- ment of this fearful malady, and to give the weight of expe- rience for and against their use. The cause being non-cognizable, we must appeal to the experience of careful and honest ob- servers, in order to enable us to judiciously select our remedies. Those who have had the most extended experience do not favor the free use of mercurials. There are but few who recom- mend emetics. The use of purgatives are often indicated, but they should be of a mild, laxative character, and simply unload the bowels without producing a depressing effect. The primary effect of cold applied to the head and spine has, in the hands of a large majority of observers, been attended with beneficial results. It should not be used until after reac- tion, and only when there is heat of the surface, and in deci- dedly febrile cases. In the first stage, or when there is chilli- ness this remedy is inadmissible. We have not found quinine beneficial, unless there is a de- cided periodicity in the disease. Prof. Jewell has examined many authorities, and gives it as his opinion that a large ma- jority are against its use. Drs. Noble, Wales, and Palmer, are of the opinion that strychnine, when early employed, is a valuable remedial agent. In the preparation of this paper we have not aimed at giving more than a general outline of the nature and treatment of this fearful malady. It would extend it far beyond the patience of the members of this society, if we were to enter into the de- tails of treatment. Therefore, these remarks are respectfully submitted to your consideration.

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The Principles and Practice of Disinfection. By Roberts Bartholew, A.M., M.D., Professor Materia Medica and Therapeutics in the Medical College of Ohio, etc., etc., etc. Cincinnati: R. W. Carroll & Co., West 4th Street. 1867. This is a very neatly printed monograph of 111 pages. It may be read with pleasure and profit by all who are interested in the important subject of disinfection.

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DIABETES. By H. BENCE JONES, A.M, M.D., F.R.S., late Phy'n to St. George's Hospital. (Lectures on Pathology and Therapeutics.} Dr. Jones, in speaking of the treatment of diabetes, in his elaborate work on Pathology and Therapeutics, says, that the effect of diet is far beyond that of any known remedy. An anti-farinaceous, or in other words, an anti-saccharine diet, will remove the sugar from the urine, and stop all the symptoms of the complaint in all those cases in which the power of consum- ing the animal sugar remains unaffected. Even when the con- sumption of the animal sugar is imperfect or impossible, an anti-saccharine diet will lessen the thirst, the flow of water, the dryness of the mouth, and even the constipation, and check, thpugh it may not stop, the waste. The simplest formula for the diet may be thus stated. All animal produce, including fish, flesh, fowl, ?game, eggs, cream, and meat-soup, should be taken; and all vegetable food that contains starch, dextrine, and sugar should be avoided. The vegetable substances that con- tain most starch, dextrin, and sugar are rice, maize, arrowroot, sago, potatoes, oatmeal, peas, beans, biscuit, toast, maccaroni, vermicelli, and all confectionery. Fruits are even worse than vegetables. Apricots, plums, peaches, cherries, pears, and gooseberries are nearly as bad, and some worse, than rice or maize. Stout, porter, and ale, cider, port, madeira, champagne, and sherry are more or less highly saccharine; cocoa and cho- colate contain nearly 20 per cent, of starch and dextrine natu- rally, and more is often added. As regards the use of medicines in diabetes, Dr. Jones is of opinion that there are two ends to be gained by their use; the first and most important is to promote the oxidation of the sugar; or, failing this, to compensate the system for the loss of saccharine fuel, and the consequent loss of power and nutrition by promoting the supply and oxidation of the oleaginous fuel. Of all the medicines that can be given for the promotion of the oxidation, whether of sugar or fat in the body, iron and alkalies are the most energetic; and hence, beyond all other remedies, iron or the ammonia-citrate of iron with excess of ammonia, or with other alkalies, are usually the best medicines for diabetes. The iron may be given in potass or Vichy, or in Fachingen water, and that preparation which confines the bowels least is most to be preferred. Hence, the potassio-tartrate and Grif- fith's mixture are often useful. Alkalies without iron promote oxidation. Soda or potass may be given in the caustic state, or as carbonates. Carbonate of ammonia in ten, fifteen, or twenty grain doses thrice daily, in any gaseous mineral water, lessens the thirst. Besides alkalies some animal substances are thought to pro- mote change in the sugar in diabetes. Of these rennet and pepsine may be mentioned; but Dr. Jones is not satisfied that either are very useful. Vegetable and animal oils and fats constitute important rem- edies in diabetes. Of all these cod-liver oil and cream are most frequently used. The following case may be taken as an in- stance of the amount of cod-liver oil that can be given:-- A man, aged twenty-four years, was admitted into St. George's Hospital, having lost two stone in weight during eight months. He passed seven quarts of urine daily. He remained under treatment for a month, during which time he was on ani- mal diet and cod-liver oil. He began with half an ounce daily, and this was gradually increased up to eight ounces. The quantity of urine fell to two pints and a half, specific gravity 1030, and he increased in weight from 8st. 81b. to 9st. lib. Cream may be given in any quantity until the tongue begins to be coated, then it soon disagrees, and the stomach refuses to take it, or rejects it when taken. Pure glycerine may be employed as a substitute for sugar in tea, and in other liquids. To lessen the thirst, and the craving for food, opium is very useful--five or ten grains of Dover's powder, or five or ten drops of laudanum, may be given once or twice daily. The second great object in the treatment of diabetes is to remove the constipation. Notwithstanding the amount of food eaten, the action of the bowels usually is very difficult. All saline aperients increase the thirst, and pass off by the urine. Magnesia, from the ab sence of acidity, is usually inactive. Castor oil is by far the best aperient, when it does not nauseate, then capsules con- taining castor oil, with minute quantities of croton oil, are most efficacious. Compound extract of colocynth with jalapine, scam- mony, or gamboge, or podophyllin, will act when oil cannot be taken. Calomel may be used as an aperient, but it has not any advantage over other chemical or mechanical irritants to the mucous membrane of the bowels.

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Essentials of the Principles and Practice of Medicine. A Handy-book for Students and Practitioners. By Henry Hartshorne, M.D., Professor of Hygiene in the University of Pennsylvania, etc., etc., etc. Philadelphia: Henry C. Lea. 1867. This is a small-sized octavo volume, of 417 closely printed pages. It opens with an introductory chapter on Medical Sys- tems or Theories, which gives a brief but interesting resume of medical history. Then follows four sections under the head of Principles of Medicine. The first is devoted to General Patholo- gy; the second to Semeiology; the third to General Therapeu- tics; and the forth to Nosology. These sections occupy about 100 pages. Part Second is devoted to Special Pathology and Practice, and embraces a very brief consideration of all the diseases usually included in works on practical medicine. It closes with several pages of Formula referred to in the body of the work, and a copious index. As a sylabus or abstract of practical medicine and pathology, this little work of Dr. Harts- horne is the best that has come under our observation. For sale by S. C. Griggs & Co. Price, $2.63.

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LOCAL ANESTHESIA. Bellefontaine, Iowa, Aug. 4th, 1867. N. S. Davis, M.D.: Dear Sir:--My attention was called to the new mode of pro- ducing local anaesthesia, (in the number of the Medical Exam- iner, for August, 1866,) invented by Dr. Richardson, of London, and was determined to give it a trial. Accordingly, I purchased an ayparatus, and commenced experiments. I first tried it for destroying sensation in the teeth, for the purpose of extracting without pain. The result was very unsatisfactory in every case, owing to the abundance of saliva in the vicinity of the molars. It was almost impossible to accomplish freezing, and when I succeeded in doing so it was followed by no diminu- tion in the pain of extraction, besides the operation itself being very painful. I next tried it for the purpose of making inci- sions of a necrosed portion of the ostibia, in a young man, but without success; the narcotism never penetrating to the depth of over y'g of an inch. I then tried it in a case of carbuncle; then a common boil, and lastly in a case of whitlow, after which I abandoned it in disgust. The fluid used was rhigoline. I have very frequently tried it on my own fingers, and found it very painful, besides being followed every time by inflammation to some extent. Such is my brief experience with the spray producer, from which I pronounce the whole thing a failure. Respectfully yours, D. SCOTT, M.D.

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ARTICLE XL. HOMEOPATHIC LIFE INSURANCE. By S. R. MILLARD, M.D., of Aurora, Ill. Among the many humbugs that have arisen, in cloudy and mysterious shapes, in the domain of medicine, none has been more vapory, and none is destined to be more evanescent than that known as homoeopathy. It arose in Germany, passed westward, and loomed up in great proportions on the American continent, becoming more and more attenuated as it spread and swelled, till it now no longer casts even a shadow where the light of true medical science falls. It has always been apparent to us, that those leaving the regular school to practice upon the whims of Hahnemann, were shallow minded and impracticable men, more fitted to be in- mates of a lunatic asylum, or a charity hospital, than for the important work of curing the sick, and saving human life. But the extreme of absurd pretension, the very sublimation of folly, was not reached till a few months ago, when a parcel of men in Cleveland organized a Life Insurance Company, for the pur- pose of insuring the patrons of homoeopathy at rates ten per cent, less than the patrons of scientific medicine. For a time, when we read of this lilliputian scheme, we con- sidered it only a joke upon our "sugar pill" neighbors; but before long there came agents and circulars, and ratio and tables, with veritable officers and boards of reference, looking, for all the world, like a real and live life insurance company. Witnessing such a bold and determined movement, we began to question if it could be possible that the lay members of that fantastic school, possessed of more brains and practical sense than the physicians could well and truly run a life insurance company. Before we were done considering this question, and the probable effects of the enterprise upon our own profession and practice ; before we could draw our bow and let slip an arrow at the head of the approaching monster, another par- cel of men, at Albany, N. Y., set crazy by the brilliant prospects of the Ohio institution, seeing great glory and abundant gains in such an undertaking, got up another com- pany, offering to insure homoeopaths for ten per cent, less pre- mium than the patrons of rational medicine. This new concern seemed not quite so ready to cut loose from the old anchorage, but wisely kept half its pigeon holes for old school risks, or, m other words, prepared itself for carrying water conveniently on both shoulders. Feeling some curiosity as to the interior of life insurance, and the modus operandi of the business, we got manuals, and posted up on the subject, far enough to form some opinion as to the tendency of these new movements. For the first time we learned the nature of mortality tables, of premium reserves, and various kinds of policies. As the result of our investiga- tion we found no cause for alarm. The first company organized, had it received the united and full support of the "sugar pill" people in this country, would possibly have grown to be a power for evil; its influence for a time, at least, would have hurt us. But this second company coming into the field, with its guns more set against the first one than against the old fashioned companies will save us all labor and all care on the subject. If the Albany company makes up its dividends honestly, in its two sections, we confidently predict that the patrons of reg- ular medicine will receive greater profits, by at least fifteen per cent., than the patrons of homoeopathy. Instead, therefore, of being hurt by this new opposition, we expect to be greatly benefited by it. Haman may swing again upon his own gallows. This whole business but demonstrates anew the utter incom- petency of these attenuated minds, to organize or manage any institution of importance. In the absence of a proper educa- tion, ignorance and conceit will always lead them into most ridiculous blunders. If they start off apparently well, they soon get at variance, fight each other, and thus destroy what little they might otherwise accomplish. We now wonder what next? Nothing from the shades of of shadowy moonshine, the mystic realms of homoeopathy, can hereafter frighten or even astonish us.

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QUINCY MEDICAL SOCIETY. The first quarterly meeting of the Quincy Medical Society was held at the office of Dr. Zimmermann, of Quincy, August 13tli, 1867, at 10 o'clock A.M. A quorum being present, the meeting was organized by the election of Dr. L. H. Baker, Chairman, in the absence of the President, Dr. C. A. W. Zimmermann. The Secretary read the proceedings of the last two meetings, which were approved. Dr. John S. Lower then moved that the Constitution and By- Laws proposed at the meeting held the 18th day of June last be adopted by this Society. This motion being seconded, was put and carried by a unanimous vote. The amended Constitution makes it necessary for every mem- ber, in order to receive the right of suffrage, to present his cre- dentials to the Society to be approved by a unanimous vote. The Secretary then proceeded to present the credentials of nine of the twenty-nine members who compose the Quincy Medical Society, thirteen of whom reside in Adams County. After due examination of their credentials they were severally approved and the right of suffrage in this Society conferred upon the holders of each by a unanimous vote. The following were the credentials presented, viz.: 1. A Degree of Doctor of Medicine conferred upon John S. Lower, of Quincy, by the Cincinnati College of Medicine and Surgery, February 19th, 1845. 2. A Degree of Doctor of Medicine conferred upon Leander H. Baker, of Quincy, by the Louisville Medical Institute, March 3d, 1842. 3. A Degree of Doctor of Medicine conferred upon Addison Niles, of Quincy, by the Geneva Medical College, August 15th, 1835. 4. The credentials of C. A. W. Zimmerman, of Quincy, showing that he received a Degree of Doctor of Medicine con- ferred by the University of Gottingen, March 10th, 1835. 5. A Degree of Doctor of Medicine conferred by the Uni- versity of Wursburg, June 4th, 1863, upon William Zimmer- man, of Quincy. 6. A Degree of Doctor of Medicine conferred upon Joseph H. Reynolds, of Payson, by the Bellevue Hospital Medical College, March 1st, 1864. 7. A Degree of Doctor of Medicine conferred upon William Sigsbee, of Ellington, by the Castleton Medical College, June 16th, 1852. 8. A license to practice physic and surgery conferred upon Weller D. Rood, of Fowler, by the Onondaga County Medical Society, June 14th, 1840. 9. A license to practice physic and surgery conferred upon Andrew J. Miller, of Stone Prairie, by the Quincy Medical So- ciety, Nov. 14th, 1865. The Secretary then read a fee bill which had been proposed by the advice and concurrence of several members of the Quincy Medical Society. On motion of Dr. William Zimmermann, it was unanimously adopted, and a Committee appointed to revise the same and re- port at the next regular meeting. The Chairman appointed the following Committee for that purpose: Dr. A. Niles, Dr. William Zimmermann, and Dr. E. D. Helms. The Secretary called the attention of the Society to the re- solutions which were adopted by the East River Association of New York, June 20th, 1867, and published in the Medical Re- corder, Aug. 1st, 1867, as follows: Whereas, The attention of this Society has been called to consider the propriety of taking action relative to the practice of druggists renewing prescriptions of physicians without their written order, thereby injuring very materially the pecuniary interests of the profession, without gaining any particular be- nefit to themselves; and Whereas, In view of the graver and more important consid- erations, that the interest and lives of patients are in conse- quence endangered, we consider it a duty to guard to the utmost of our ability against the liability to mistakes, which should be prevented rather than deplored; be it, therefore, Resolved, That we cordially invite the earnest cooperation of every druggist in this city, especially in our immediate districts, to further this laudable purpose; and be it further Resolved, That we respectfully request that no druggist will renew the prescriptions of any physician connected with this Society, without due authority for each and eVery such re- newal; further, we will regard as unworthy of patronage any druggist who fails to comply with the requirements of these resolutions. Resolved, That a copy of these resolutions, with a blank card, be sent to each and every druggist in our districts, with a request that the card be returned within two weeks to the Sec- retary, signifying their intentions with reference to compliance with these resolutions. On motion, the above resolutions were adopted by the Quincy Medical Society, and the Secretary requested to present a copy to every druggist in the city, for his approval or dissent. The Secretary reported that he communicated to the Secre- retary of the Adams County Medical Society the resolution adopted by the Quincy Medical Society, at its last meeting, as follows: Whereas, A resolution was adopted by the Adams County Medical Society, held May 14th, 1767, inviting the Illinois State Medical Society to hold its next annual meeting in this city, which invitation has been accepted by the State Society; therefore Resolved, That we cordially approve the measure, and hold ourselves in readiness to cooperate with the Adams County So- ciety in making the necessary arrangements. For this end the Quincy Medical Society authorizes the President to appoint a Committee to confer with the Adams County Medical Society on the subject, and likewise to consider any propositions which may be brought forward to harmonize and unite the medical faculty in this city and county. In accordance with the above resolution, the President ap- pointed the following Committee, viz.: Dr. E. D. Helms, John S. Lower, and L. II. Baker, of this city. On motion of Dr. E. D. Helms, Dr. C. A. W. Zimmermann was added to the Committee. Up to this date no official answer has been received from this communication. On motion, the Society adjourned. ADDISON NILES, Secretary.

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The Quarterly Journal of Psycological Medicine and Medical Jurisprudence. Edited by Wm. A. Hammond, M.D., etc. New York: A. Sampson & Co. We have just received the first number of this new Quarterly. It is published in excellent style; the type and paper being of the best quality. It contains 160 pages of reading matter; and is devoted to a most important field of medical study and literature. We earnestly hope it will meet with an abundant patronage. Subscription price $5 per annum, or $1.50 for single copies. Published at 60 Duane Street, New York.

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Prize Essay on Vital Statistics. By Franklin B. Hough, M.D., of Lowville, N. Y. This is a pamphlet of 37 pages, being the Essay to which was awarded the Brinsmade prize of $100, by the New York State Medical Society, in February, 1867. The subject of which it treats is of great importance. One of the leading objects of the writer was to present a feasable plan for making and tabu- lating hospital reports, records of private practice in medicine, surgery, and obstetrics; together with the draft of a law for the registration of births, marriages, and deaths. We have not had time to examine the plan presented, but will endeavor to refer to it again at a future time.

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RATIO OF DEATHS FROM CHLOROFORM IN ENG- LAND. London, July 13, 1867. The London surgeons, with the exception of Dr. Protheroe Smith, and part of the officers of Guy's Hospital, have, with one consent, settled themselves down in the comfortable delu- sion that the risk of chloroform is scarcely worth considering. I find them just like Americans in one thing--they hate sta- tistics. When I ask them what the actual risk of chloroformi- zation is, they reply, " Oh, a very trifle, a mere nothing." The celebrated Mr. Simon, of Guy's Hospital, told me that it was in his opinion safer to take chloroform than to take a ride on a railroad. Others, when pressed for an opinion, generally fall back on Mr. Sansom's Handbook on Chloroform, which esti- mates the deaths from Chloroform to be only one out of every 17,000 persons taking it. This may be set down as the opinion of the mass of London surgeons, both eminent and otherwise. Now, while they are gliding along in this agreeable state of mind, I have been at work to gather facts, and I find that in- stead of one death in 17,000, one patient dies out of every 3,461 anesthetized, in the very hospitals where these gentlemen are at work. In other words, the deaths from chloroform un- der their own hands are about five times as numerous as they state, and as Mr. Sansom's Handbook estimates. If there were a railroad in London which killed one out of every 3,461 of its passengers, I imagine one would hesitate to buy a ticket on it. In examining Mr. Sansom's statistics, to see how he arrives at his surprising estimate, I find the reason of his error. He omits entirely the London hospitals, and takes no note of the fact that several deaths from chloroform occurred in the very one of which he was an officer. He obtains from some source an estimate of the number of times the article had been given in the hospitals of Birmingham, and other inland cities, Com $uonde nre amounting in all to 17,000 times. In these hospitals only one death from its use had "been reported," ergo chloroform causes only one death in 17,000 cases. Now, the very first step which I made in this investigation showed me that many deaths from anesthetics occur both in this country and America, which are never publicly reported. There are no regular statistics of anesthesia kept in any hospital here, that I have yet found, and as a chloroform death is an ugly, uncomfortable fact, it usually slumbers unnoticed by the records. The difficulties of my in- vestigation, therefore, have been very great. My mode of ob- taining the facts had been this. I have made careful personal inquiries of the surgeons, house surgeons, dressers, and secre- taries of every hospital which I have visted, as to the two points, viz.: the number of times per annum chloroform has been given, as far back as their means of information extend, and, secondly, the number of deaths it has occasioned in the same period. These officers usually have no difficulty in esti- mating approximately the number of administrations per an- num which have occurred for several years, and the deaths during the same periods. In this way I have collected figures from fourteen hospitals in Liverpool and London. I obtained reliable accounts of chloroform being administered eighty-three thousand fifty-nine times, (83,059,) and of these, twenty-four (24) proved fatal, or one in three thousand four hundred and sixty-one, (3,461.) Now, if this is "safer than riding on a railroad," then I shall buy no more railroad tickets. A rail- road in active business which should have a mortality like this would kill from 500 to 3,000 passengers every year. I shall continue my investigations on this subject both here and in France, and will report any new facts which I may ascertain. Some of the hospitals here are a little uneasy, after all, and are using a new inhaler for safety, called Clover's apparatus, the principle of which is to inhale from a large air sack, which is inflated by a bellows, of a known capacity. The air, in pass- ing from the bellows, goes through a hot evaporator, containing just enough chloroform by measure to give 3 or 3| per cent, of chloroform vapor to the air in the sack. The huge, black bag, about 3 feet long and 2| feet wide, is slung on the back of an assistant, looking like the burden in the pictures on the back of Bunyan's Pilgrim. A large tube passes under his arm, termi- nated by an inhaler so arranged with valves that the patient inspires from the bag and expires into the open air. It is too clumsy for private practice, but works well in hospital, and probably promotes safety, as the patient cannot possibly get more than the per cent, of chloroform vapor which is placed in the sack. It has not been used enough yet to test, practically, the per cent, of mortality under it. For the present, therefore, it would seem to be our duty to use ether in all cases in which the patient can be readily brought under its influence, and to reserve chloroform for those whom ether will not subdue. Possibly the tetrachloride of carbon, now being introduced by Dr. Protheroe Smith, may prove to have the safety of ether and the promptness of chloroform. If so, all good surgeons will rejoice. I should have stated that my chloroform statistics are gathered exclusively from surgical cases, and are of no value in determining the safety of the ar- ticle in midwifery. Notwithstanding the deficiency of Mr. Sansom's book, in es- timating the real danger of chloroform, it will be found to con- tain very valuable information on other branches of the subject, together with the Report of the Committee of the Royal Medi- cal and Chirurgical Society, in 1864, may be said to contain the best results of English investigation up to the present date. EDMUND ANDREWS, M.D. 23 Cecil Street, Strand, London.

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A CASE OF EXCISION OF THE CERVIX UTERI. In recently looking over an old volume of Surgery, (The Art of Surgery, etc., by Daniel Turner, M.D., London, 1736,) we came across the following interesting case. The operation per- formed on the patient herself, is evidently the same as that re- cently proposed by Huguier for so-called procidentia, and which is now attracting so much attention. The case is narrated under the heading "Of a Procidentia Uteri, ac Prolapsus Va- ginae ejus." We transcribe it entire, believing it will be of in- terest to the profession, not alone on account of its novelty and the quaintness of the narrative, but also from the fact that it is probably the first case on record of this operation for the cure of procidentia: An elderly woman, having been for some years crazy, as well in her head, I mean her intellect, as her body, and longer in- commoded with a procidentia uteri, which she was forced to keep up with her string-cloth, being otherwise scarce able to move about the house; under a fit of melancholy, was ponder- ing how to free herself from this inconvenience, and unknown to any person of the family, taking her opportunity, first putting herself in a suitable posture, with one hand she draws down the prolapsed body, whilst with her husband's razor in the other, got as it were, by stealth, she excised all within her reach; then, putting a clout up to the parts, she got into her bed; where, after short time the blood being discovered, and she questioned about it, she very sedately told them what she had done. Upon this a neighboring surgeon was sent for, who restrained the haemorrhage with proper restringents: but in the evening, the flux being renewed, he called me to his assistance: when, ordering a large tent, like a pessus, to be made up, the same was dipped in oxycrat. cum alb. ovorum, then gently expressed and rolled over some fine bole, particularly its extremity, and so put up; next to this, a thick pledget, or wad of tow, wrung out of the same, and sprinkled thick cum farina fabar, with the T-bandage to keep all close. The day following, the blood seemingly staunched, a diges- tive was got ready, into which made warm, a tent like the first was dipped and introduced: but coming the third day, we found more blood discharged, several grumes, or clots, following the extraction of this last application; so that we were forced to have recourse to our restringents: and thus we continued for several days, our patient all this while calm, with little fever, and as little complaint, in regard to what might have been ex- pected from so desperate an operation. When the flux was stopped, and the external privity cleansed with a warm stuph wrung out of wine, we took a more strict survey of the parts, and dilating the labia with my fingers, in expectation of finding a wound on the relaxed vagina, could perceive nothing like it, all lying fair and natural within our sight: when, entering my finger as high up as I could reach, I plainly felt a large jagged or unequal wound, on the lower part of the uterus, whose os internum, or whole cervix, had been cut off: the blood, upon this examination (though but in small quantity) again following my finger. I then inquired after the part thus strangely taken off, which they shewed me put by in water, and I perceived it, as I have represented, the upper part an inch and a half deep, especially on each side, somewhat narrower in the middle, and still less on the under part, or that lying on the rectum, which, for the cu- riosity, I desired the surgeon to put into spirit of wine, and which he still keeps by him, to gratify the ingenuous inquirer with a sight thereof; of which number the first person I showed it to was Mr. Petty, in Fenchurch street: but, proceeding, After this discovery, the blood also entirely restrained, I ad- vised a large tent to be made up, as at first, whose upper ex- tremity was dipped in a melted mixture, ex part, iij., vel cerci- ter, linimenti arcaei, cum quarta ol. tereb., passing it up against the gaping wound of the uterus; I also advised a warm fomen- tation, which we were shy of sooner, on account of the haemorr- hage, prepared ex Decocto fol. absinth, cent, hyper, etc., and a proportionate quantity of the spir. vin. camph. to be applied with stuphs, not only to the pudendum, but reaching up to the lower belly, which were renewed for half an hour, night and morning, before the time of dressing up, whereby to comfort the internal parts thereof, cherish their heat, and promote di- gestion of the wound; which, after ten days, began to appear laudable upon the end of the tent, and in moderate quantity. After this a womb-syringe was provided, and the following decoction thrown in twice a day, by way of injection, to mun- dify the wound; by its situation I apprehended it less suscep- tible of an impression of our balsams, which were, however, still continued after the use thereof. 1$4.--Plantag. cum toto, summit, hyperic. centaur, ana, m. j. hord. gallic, 5 ss. coquantur in aq. font. q. s. pro tbi. colaturae, cui per subsidentiam depuratae adde mel rosar. SSij. tine, myrrh. 5 ss. et f. mixtura, cujus, metrenchitae ^auxilio, injiciantur coc- hlear. v. vel vi. per sinum Pudoris, prius tepefacta, bis in die. This having been used for some days, and the discharge still lessening, I substituted the following, more consolidating and agglutinating: 1^.--Rad. de symphyto, plantag. ana SSi. fol. hyperic. equi- seti, saniculae, bugulae, ana m. ss. coquantur in aq. font. q. s. ad gxij. colaturae, sub sinem infundendo vini rub. SSiv. et prete- rea colature suprascriptoe addendo mel rosar. SSij. f. pro injec- tione prioris instar utenda, sed saepius in die. By which I have great hopes her cure may be accomplished; she now gets out of bed, takes her nourishment and rest, the discharge from the wound being inconsiderable; and the same bidding fair for healing suddenly. I think this is, if not the only instance of the niseratomia, yet surely of the uteri cervicis abscissio, I remember to have met with in our writers of chirurgery; at least I am apt to be- lieve the first attempt at this way, for the cure of its prolapsus. --Journal of Practical Medicine and Surgery.

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m tr im. DIABETIC PHTHISIS AND ITS TREATMENT. By B. W. RICHARDSON, M.D. The physician who has occasion to treat large numbers of patients suffering from phthisis pulmonalis soon becomes aware of the fact that the disease is not a single and simple organic lesion depending only on one primary condition, but that, mani- festing a remarkable unity in respect to symtoms, it may ex- hibit as remarkable a diversity in relation to cause, and may be allied with many and varying forms of disease. Thus there is a true form of phthisis connected with alcoholic degeneration of the tissues--alcoholic phthisis; there is a form of phthisis in children connected with cyanosis--cyanotic phthisis; there is a bronchial phthisis; there is a form of phthisis from inhala- tion of foreign substances--mechanically excited phthisis; there is the ordinary phthisis of the young, hereditary or ac- quired; and, lastly, there is the peculiar form of phthisis which is sometimes coincident with diabetes, and to which I would now direct attention--diabetic phthisis. Diabetic phthisis is, by comparison, a rare disease. In the course of twelve years' practice at the Royal Infirmary for Disease of the Chest I have met with not more than eight cases, and in private practice I have met with three only. On the whole, juding from experience, I should think that of fifteen hundred cases of a phthisical character, not more than one would be a case of diabetic phthisis. Further, the disease dia- betes may prove fatal without any of the symptoms of phthisis. For all this, diabetic phthisis, when once set up, is a well marked form of disease: it is something more than a complica- tion of diabetes when it appears, for it soon stands out first, and becomes the actual life-destroyer. In three of my cases the patients presented themselves, un- conscious that they were eliminating large quantities of sugar by the urine, and complaining solely of the affection of the chest. In all the other cases the symptoms of diabetes had been recognized prior to the development of pulmonary mis- chief; this, I have no doubt, is the general rule, and I believe in every case where the history of the symptoms can be clearly traced it will be found that the diabetes was the antecedent affection, although the patient was not conversant of the fact. When in the course of diabetes the phthisical condition is devel- oped, the newly diseased state is not usually an early complica- tion; but, once developed, it speedily runs its fatal course. The first general symptom is severe hectic, the hot stage of which is very extreme, and, instead of being followed by pro- fuse sweating, is succeeded by great coldness of the surface of the body, depression, and copious elimination of urine. Diffi- culty of breathing is a marked symptom ; cough is common, but is usually hacking only, and is unattended with any quantity of expectoration. Haemoptysis, in the strict sense of the word, I have not seen; but sputa of a rusty character, in small quan- tities, is freque>>t. There is little acute, thoracic pain, but great oppression. Waste of bodily substance is extreme. The physical signs are well marked. If the disease is seen early, patches of lung, like so many centres, give signs of dry crepitation; rapidly this crepitation extends over the whole lung. In one of my cases, during the last six weeks of life I could put the stethoscope over no part of the chest without hearing crepitation. The crepitation is distinctly that of early tubercle; it is wanting in the fineness of early pneumonic cre- pitation. In course of time there is some tendency to softening of tubercle, but this is very limited, and I have but once ob- served the actual formation of cavity. Death takes place, in fact, too early to give time to give time for softening or absorp- tion of tubercle; added to this, the diabetic condition seems to interfere with the process of softening, probably by t^e remo- val of water from the tissues. Percussion over the chest, where there is crepitation may be dull, but this sign is not essential. Whenever there is clearly developed diabetic phthisis the prognosis is inevitably bad, according to our present knowledge of treatment. Further, the prognosis is almost definite as to time; I have not seen a case that survived four months after the tubercular condition had been obviously present. From six to ten weeks is the common duration of the term of life from the period of severe and definitely recurring hectic. After death the condition of lung is peculiar, and in three cases--the only cases I could be allowed to inspect--the condi- tion was the same. The lungs were much shrunken and dry; they were greyish and darkly mottled in color; the tissue was filled with small dark--I had almost said gritty--tubercle, and there were a few patches of deep vascular congestion. There was no pleuritic adhesion, no serious effusion, no pulmonary cavity. In every case of diabetic phthisis I have seen there has been disease of the base of the brain. In one case there was a growth of bone pressing upon the under surface of the medulla oblongata; in another case there was softening of brain sub- stance, and in a third case there was disease of the vessels with thickening of the membranes and old adhesions. In one of these cases the patient had been under the late Dr. Bayly for "acute meningitis," and his symptoms of diabetes followed that attack immediately. As he recovered from his acute illness he discovered himself diabetic. The pathological relationship of diabetes and phthisis of the lung seems to me to be through the nervous system. That there is a functional and an organic type of diabetes; that the functional type is largely curable, and the organic absolutely incurable; and that the functional type is connected with a false digestion, owing to temporary interference with nerve action-- these, I think, are facts which every scientific physician must be prepared to accept. Some difference of opinion, however, yet exists as to the re- lationship of diabetes to disease of the brain. The progress of experimental inquiry has all been to the effect that lesion of brain structure is an efficient cause of the diabetic condition; but Dr. Ogle has recently, in a most labored and able paper, maintained that the brain lesion sometimes found in diabetes is a result of structural change incident to the diabetic state, and a result instead of a cause. I do not propose to discuss this refined question now, but I would point out that when phthisis of the lung is developed during diabetes, the morbid change appears to be the result of what may truly be called inervation of the lung tissue. That the change is not due merely to modi- fication of the blood is certain from the fact that diabetes may exist or prove fatal without the occurrence of pulmonary phthi- sis or any sign of it. The occurrence of the phthisis also takes place, as I think experience shows, only when the diabetes de- pends on lesion at the base of the brain. It is fair to presume, therefore, that in such cases the nervous injury has so extended as to involve at their source the nerves from which the pulmonic structure is supplied. Regarding treatment in diabetic phthisis, I have tried various plans--oxygen by inhalation, oxygen by per-oxide of hydrogen, special diet, change of air--and all to no purpose. Still there are certain points of practice which are worthy of note. I name two especially: 1. I am convinced that in this malady oxygen and its allies, chlorine, iodine, or their compounds, do harm: they increase elimination, and reduce accordingly. 2. I am equally certain that a diet restricted to albuminous products is utterly wrong, both in theory and in practice. I believe that in functional diabetes a great duty can be effected by restricted diet, coupled with the method first suggested by Rollo, of giving with such diet ammonia and iron freely. I doubt, however, the practice of restricted diet in every case of organic diabetes, and in cases where there is the faintest indica- tion of phthisis the restricted diet becomes, I feel sure, a posi- tive evil. So soon as diabetic phthisis is established, the gene- ral dietetic rules for phthisis alone are the rules, and the only rules, to follow. In the way of affirmative treatment the prin- ciples are--to sustain warmth of body, to check waste by opium and quinine, and to sustain by good food, especially by the free use of animal oil. In the next case I have to treat I will give animal oil, not by the spoonful, but by a half-pint at a time. I will give it as the Esquimaux takes it, and for the same reason, to sustain the lost caloric in his case, too rapidly carried away by the surrounding cold, and in the case of the diabetic man by the excessive formation, dissolution, and elimination of sugar. To this last remark I would add that, in respect to the treat- ment of organic diabetes altogether, there is more hope in the free use of animal oil than in any other remedy. Here is an unexplored field of practice before us, a very simple practice, and easily put to the test, but a practice strictly rational and based on the true institutes of medicine.--Medical Times and Gazette. >

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ARTICLE XLI. POISONING BY STRYCHNINE.--RECOVERY. By STACY HEMENWAY, Eugene City, Oregon. Having noticed the recovery of two cases of poisoning from strychnine, recently reported through your valuable journal, one by S. A. McWilliams, A.M., M.D., and the other by Julien S. Sherman, M.D., both of Chicago, Ill., I deem it of equal importance to relate another case of recovery from poi- soning by strychnine, -which occurred seven miles south of this place, on the 5th of June, 1867. James G., a resident of Lane County, Oregon, cet. 28, swal- lowed a quahtity of strychnine, accidentally, at about half-past 8 o'clock in the morning. It occurred about as follows: The patient had been in the habit of putting strychnine out to kill the "varmints," as he termed them, and had carelessly left upon the table a moistened teaspoon which he had been using in the finely powdered substance, a considerable quantity ad- hering to the spoon. On the morning in question he had taken up a pail to go out and milk, but discovered before he started, (he perhaps being somewhat under the influence of an alcoholic stimulus at the time,) a cup on the table containing milk, which he desired to drink. He picked up this spoon with which to stir the cream into the milk, and thus thoughtlessly swallowed the mixture. He stated that immediately after taking the poison every- thing seemed to turn green, and that he suddenly fell to the floor, with inability to move his limbs, while his whole muscular system was in a state of tremor. He remained unable to move until about 2 o'clock P.M., and was unfortunately entirely alone. The nearest house was perhaps a fourth of a mile off', which he succeeded in reaching in the course of two hours by crawling and walking at intervals between the spasms, which were of frequent occurrence. Vomiting occurred once on the way. A messenger was now sent in haste for me. I reached the patient at about 8 o'clock P.M., nearly twelve hours after the swallowing of the poison, and found him suffering from the characteristic symptoms of poisoning by strychnine, having spasms, extensive, frequent, and severe, and excessive spitting of frothy saliva. About five minutes after my arrival a severe convulsive paroxysm occurred, which lasted twenty minutes. These violent spasms occurred at intervals of about half an hour, and about four thrills per minute passing through the system. He was suffering, also, from spasmodic contraction of the muscles of the chest about four times in a minute, with a feeling of impending suffocation. There was marked rigidity of the cervical muscles, the jaws set, and he complained of a sense of constriction of the fauces, with difficulty of swallowing. The extremities were cool; countenance anxious; pulse 110 to the minute, and the mind clear and sensible. Having with me the cannabis indica, in the form of the alcoholic extract, (the tincture being unobtainable at the time.) I immediately ad- ministered from 4 to 5 grains in pilular form, and repeated the dose in five minutes; then four similar doses at intervals of ten minutes; afterwards three such doses at intervals of fifteen minutes, with a rapid improvement of the symptoms. Svmn- toms of the intoxicating effects of this drug began now to be slightly manifested. The administration of the remedy was suspended for an hour, and then resumed again, in gradually diminished quantities, alternated with spts. camphor in drachm doses, every fifteen minutes, until four doses of each had been administered, when the patient began to be comparatively quiet, with a strong tendency to sleep. He began to sleep well at 2 o'clock A.M.; left directions with an attendant to administer a similar dose of each, one hour apart. During the administra- tion of these remedies, the spasms gradually grew less violent, together with a gradual diminution, in severity, of the tremu- lous movements running through the system. The patient slept well, until late in the morning, when he awoke, complain- ing of extreme exhaustion, with general muscular soreness. A very slight thrilling sensation running through the system still prevailed. The patient was directed to take one 3 grain pill of the ext. cannabis indica every two hours for 6 hours, alternated with drachm doses of the spts. camphor. Nutritious diet with tonics soon rendered recovery complete.

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CHRONIC METRITIS--PROF. SCANZONI'S TREAT- MENT. Prof. Scanzoni, of Wurtzburg, has never obtained any good effects from anything but the iodide of potassium, and the iodo- chloride of mercury in direct application to the uterine and va- ginal mucous membranes. He uses, for instance, a liniment containing one drachm of iodide of potassium to one ounce of glycerine, and places every night in the vagina a sponge impregnated with this fluid. The sponge is removed in the morning. This, he says, is the only method of iodine dressing which has ever been found capable of reducing in the course of two or three weeks the size and indu- ration of the inferior segment of the womb, and is infinitely preferable to the application of tincture of iodine and of iodized liniments to the inguinal regions. Scanzoni has more recently had recourse in the same manner to the introduction into the vagina of the following pomade: Hydrarg. iodo-chloridi, gr. v. Adipis, SSj. After each application of the remedy which requires the as- sistance of the speculum, the patient should keep her bed for six or eight hours. The sponge may then be extracted, and an injection of tepid water should be performed. The epithelium is in general de- stroyed in the parts which have come into contact wTith the ointment; exudation follows, and marked decrease of size of cervix. The application may be repeated several times, if ne- cessary, at intervals of ten days or a fortnight. Scanzoni has completely relinquished the practice of apply- ing tincture of iodine to the vagina or cervix. When excoria- tions are present, he prefers to all other local remedies rectified pyroligneous acid, pure or mixed with equal parts of creasote. He leaves these modifiers in contact with the ulcerated surfaces, until the sanguineous oozing has ceased, and until the part which is in general of a bright red, has required a dead white color.--Journal of Practical Medicine and Suryery.