8. Hysteria in a young woman of twenty-seven, characterized by frequent convulsive attacks and nocturnal agitation with insomnia. She improved markedly with the same doses.

9. Nervous disturbances of pregnancy in a young woman aged twenty-four, with insomnia and suicidal tendencies. Excellent results with the same doses-two grammes.

10. Anæmia in a young girl aged nineteen, with great debility and insomnia. Trional gave her quiet sleep.

We would have liked to describe the cases at greater length, but preferred to speak of the results obtained.

Trional was well borne in all the cases in which we employed it, showing a prompt and safe hypnotic action.

It occasionally happens that a patient is unable to take it as it may cause nausea, and, in rare instances, vomiting. For this reason it is best to give a fairly active purgative before the trional, which must only be administered an hour or two after eating.

It is also necessary to select light articles of food, avoiding salads, salt fish, dried fruits, etc., and especially iced or alcoholic drinks. It may be given, as we have already suggested, in wafers; it is good practice, however, to follow it with a couple of cups of infusion of linden or of chamomile, quite hot.

The use of trional may be continued for a long time, since harmful effects are never, or at least very seldom, observed. In all cases it is well to give at the same time some of the gaseous mineral waters, such as Seltzer or Apollinaris. In Spain such waters are abundant in nearly all the provinces.

Sleep occurs about half an hour after having taken the medicine; it is quiet, placid, perfectly similar to physiological sleep; the pulse and respiration, which before were restless and nervous, are quieted. It lasts for six or eight hours, giving the patient a sensation of well-being obtained with no other hypnotic.

In the second case the effects were not as evident as in the following ones, as might have been supposed when dealing with so serious a disease as bacillary meningitis. Still it was beneficial and well borne.

In the fourth and sixth cases, in which we had to deal with renal lesions, the trional was perfectly well borne, and, it being our custom to examine the urine, we failed to find any sign to disprove this statement.

In neurasthenia and the nervous disturbances of pregnancy we had already given chloral and sulfonal with negative or with harmful results; trional on the contrary gave satisfactory results.

Even in anæmia it was given with success, being well tolerated and without the phenomena observed with sulfonal.

From what we have stated, we conclude that trional is the best hypnotic known, and that it may be prescribed both in children and in weak and nervous persons with confidence in the results and without fear of damaging after-results.-Correspondencia Medica, No. 25, '96.

EXTRA-UTERINE PREGNANCY.

This is a case of extra-uterine pregnancy. The patient, aged thirtyfour years, has had four children, the youngest being about eight years of age. Three years ago she had a miscarriage at about the eighth month and the fœtus had probably been dead a week or more. She menstruated last the 6th of February. In March she did not menstruate. She suspected she was pregnant, but had no bad symptoms until the 21st of March. At that time she was taken with a sudden and severe pain in the abdomen and was confined to bed for several hours. About the time she began to think of sending for a physician the pain subsided and she did not send. Two days later she had another attack of pain, but not so severe. She then went five days, to the 28th of March, when she had another severe attack in the night which lasted several hours. On the 30th she had a still more severe attack and I was sent for. I saw her late in the evening. There was profound shock. She complained of severe pain; the extremities were cold; the face was cold; the pulse was very fast and thready and I felt sure she would not live long. I gave her a hypodermic injection of morphine and by morning she had rallied and was fairly comfortable. She was taken the next day to the Good Samaritan Hospital. Two days after going to the hospital she passed some little decidual masses. The diagnosis from the history alone was unavoidable. For years she had not missed a menstrual period until the one in March. The attacks of pain and the shock were characteristic; and finally, the expulsion of decidual masses was almost unnecessary confirmation. The physical examination did not reveal much except the uterus seemed rather fixed and there was a great deal of tenderness on the right side. The operation was done on the fourth of April. When the abdominal cavity was opened it was found filled with blood, mostly of a light chocolate color, rather thicker than normal. All through the abdominal cavity there were black clots, showing there had been an early hemorrhage and one later. Rupture of right tube had occurred and it was adherent to the omentum.

The patient did very well for twenty-four hours. After that period she began to develop a rapid pulse and the temperature went up. The temperature, which had been 101° for twenty-four hours after the operation, went up to 1021° about thirty hours after the operation and the pulse became very rapid; at one time it was 156. She had lost control of the sphincters and there were involuntary discharges from the rectum

and bladder. As she had been purged pretty freely, and as there was no tympanitis, one-fourth of a gr. of morphine was given hypodermically. By the next morning these symptoms had cleared up and her pulse had come down to 120, and she has since progressed without trouble and is making a good recovery.-Proceedings of Soc. Am. Soc.

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MEDICAL NEWS AND NOTES.

TWO CASES OF RECOVERY FROM PERNICIOUS ANAEMIA.

A Russian Army-Surgeon, Dr. M. B. Blumenau, has observed at the military hospital of Grodno a case of pernicious anæmia, which was cured with remarkable rapidity and completeness by the ingestion of bone-marrow. The patient was a soldier, twenty-three years of age, in whom the anæmia had supervened as the result of severe dysentery. Among other symptoms, he presented malleolar oedema, ascites and a certain degree of dilatation of the right half of the heart, with a systolic murmur at the apex. He was so weak as to be unable to rise. No favorable effect having been obtained by the administration of large doses. of iron and arsenic, Dr. Blumenau ordered the patient 90 grammes daily of raw-bone marrow, which he took either on bread or soup. This treatment, without any other medication, was followed by the disappearance within two months and a half of all the morbid phenomena, including weakness, cedema, ascites, and cardiac disturbances.

On the other hand, Dr. G. Dieballa, assistant of Dr. K. Kétli, Professor of Clinical Medicine at the Medical Faculty of Budapest, has had under observation a patient, fifty years of age, suffering from progressive pernicious anæmia of unknown origin (neither adult parasites nor eggs having been found in the stools), which was not relieved either by bone-marrow, iron, quinine, arsenic or inhalations of oxygen. These various substances had been administered one after the other for five months, but in spite thereof the weakness and emaciation of the patient steadily increased, and ultimately attacks of delirium supervened. Salol was then resorted to on the assumption that the disease might be due to auto-infection of intestinal origin, 1 gramme of this drug being given five times daily. Within a week the attacks of delirium ceased, the patient recovered his appetite and gained strength to such an extent that he was able to rise, which he could not do before. This improvement continued as long as salol was given. Twice an attempt was made to suspend the treatment, but each time there was a marked recrudescence of the symptoms. The administration of salol was then continued, at first at the rate of 5, and subsequently 3 grammes daily. Three months later, recovery

appeared to be definitive and the treatment was therefore discontinued. At this time the patient had completely regained his strength, and the physical signs of anæmia (pallor, bruit de souffle over the heart, enlargement of the liver and spleen, and characteristic changes in the blood) had disappeared.

Dr. I. M. Love has resigned his professorship in the Marion Sims College of Medicine.

Dr. William Thayer Smith, Professor of Physiology in Dartmouth College, has been appointed in the place left vacant by the death of Professor Carleton P. Frost.

The Paris Cour d'Appel has recognized syphilis as a reason for granting a divorce.

A New York journal claims that the death rate in Chicago is easily kept low, not by "the attention to sanitary measures, but by the estimation of the population at a much higher figure."

A Colorado journal states the following little problem as its first editorial for September, 1896. Given a young woman who says she is married, but whose husband is away at the time of the birth of her babe, that said woman refuses to nurse her babe, and that the babe wastes under artficial foods, and, as soon as the woman is able to be up and about apparently neglects the child so that the babe dies. What could be suggested in a practical way to save the life of the child? It seems to us that there are several little problems, none of which are particularly easy to solve. A babe would be apt to waste away under artificial foods that did not agree with it, and more apt to do so without any at all. Probably the foundling asylum would be the safest refuge for the unwelcome stranger.

In an editorial in the New York Medical Journal there is a brief résumé of the communications made by Dr. Juan de Dios Carrasqu'lla to the Academy of Medicine of Bogota, touching his experiments and results in the serum treatment of leprosy. "He first bleeds a leper, using an adult whose general condition is fairly good, the blood drawn varies in amount from 100 to 150 cubic centimeters. It is received into a sterilized vessel and carefully covered, kept away from the light, and, above all, kept perfectly quiet. In from twelve to twenty-four hours a superficial layer of the serum, that only which is perfectly limpid, is removed with a pipette. If it is to be kept for some time before it is to be used, it is passed through a layer of powdered camphor contained between two layers of cotton, to preserve it, and it is kept away from light and heat. Thus prepared, the serum is injected into an animal that is refractory to leprosy, preferably a healthy young horse in good condition. Roux's method of procedure is employed." The two points of

greatest importance and at the same time of most difficulty to determine, are the amount of serum to be injected at one time and the interval that should elapse between injections. He believes that 45 cubic centimeters is the proper medium dose, and should be given at intervals of ten days. The horse is bled in from five to ten days after the last injection, preferably from the jugular vein; the Nocard Roux process is followed for obtaining aseptic horse serum, and it is treated in the same way as the human serum. The dose of the serum for subcutaneous use on the human subject is from 1 to 5 cubic centimeters, according to the strength of the serum, the constitution, age, and other circumstances of the patient, the variety of the disease, and so on. The locality preferably for the injection is just to the outer side of the trochanter major. Dr. Carrasquilla has great hopes for the success of this method of treatment.

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REVIEWS.

Reference Book of Practical Therapeutics, by various authors. Edited by Frank P. Foster, M.D., editor of the New York Medical Journal, and of Foster's Encyclopedic Medical Dictionary; in two volumes, Volume I. New York: D. Appleton & Co., 1896.

"The leading idea in the preparation of this work has been to make it permanently serviceable to the practicing physician. It is not intended to take the place of treatises on Materia Medica or on pharmacy; hence, as regards the physical properties of drugs, their mineralogical and chemical potential or zoological relations, and so on, the endeavor has been to set down only so much as is of direct bearing on the use of those drugs in medical practice, or on the management of poisoning due to them." Such being the declared purposes and scope of the work, it remains for us to speak of its arrangement and of its appearance. Everything is ar ranged in alphabetical order, volume one beginning with A. B. C. Balsam, and ending in Myrtol. The name of the editor is a sufficient guarantee that the work is encyclopedic in character and entirely worthy of its title. An illustration of the "up-to-date" character of the work may be gotten from the several short articles on serum-therapy and antitoxines. The question of hydriatics or hydro-therapeutics receives extended consideration; so does, also, the question of exercise, and, indeed, it seems to us that the various authors have given a deservedly large amount of consideration to the therapeutic measures most easily available to the whole profession. For instance, climatic treatment is unusually full. The various authors have not hesitated to give accounts of drugs