other local difficulties have shown themselves in the rectum and bowels. The diarrhea has in some cases been marked, and occasionally blood has been passed in sufficient quantities to prove serious, while the vomiting has also been in these same cases quite as severe as in patients anesthetized in the usual manner. In addition, certain cases have proved quite intractable to the new mode of administration within any reasonable time, and inhalation has been added. A very few inspirations in addition to the amount absorbed by the bowels have proved sufficient.

In general the amount of ether necessary has been small; about two ounces has ordinarily proved sufficient to induce insensibility, though much larger quantities have been administered, and unpleasant symptoms have followed even from that small amount. From New York comes the account of a case, in which two ounces were administered to a child of eight months, in which bloody discharges and death occurred during the following night.

It is unnecessary to pursue the subject farther to show that these grave objections to the method will preclude its general use. Possibly it may be retained as an occasional adjuvant to the ordinary method, but it is not likely to come into general use as the ordinary method of inducing anesthesia.

The present experience has been sufficient to formulate the following rules, which should guide any one desirous of using the new method, until further experience modifies them :

Rectal etherization should be reserved for cases in which there is some special objection to the administration by inhalation.

It should be made use of only with robust adults.

In general two ounces should be regarded as a sufficient dose : that dose should be exceeded only with great caution.

When insensibility is fairly established the administration should be stopped.-Boston M. & S. Jour.

NASAL POLYPI.-Dr. William Ralph Bell (Canada Medical Record) describes a new, painless and simple method of removing nasal polypi. His patient is instructed to blow strongly through the affected nostril while he closes the other with his finger. This brings the polypus down so it can be seen. He then injects into the tumor with a hypodermic syringe fifteen or twenty minims of a solution of tannic acid in water, twenty

grains to the fluid drachm. In a few days the tumor shrivels, dries up, and comes way without trouble or pain, the patient usually removing it with the fingers or by blowing the nose.

CORROSIVE Chloride of MercURY IN RINGWORM.-In the February number of the Journal of Cutaneous and Venereal Diseases, Dr. R. W. Taylor recommends a solution of corrosive sublimate in the treatment of the various forms of ringworm. He found that the efficacy of the mercury was much enhanced by dissolving it in tincture of myrrh. The strength of the solution was four grains to the ounce. Eczema marginatum, and ringworm in general, was readily cured by thoroughly painting the affected parts with this parasiticide solution. It was applied twice daily. He believes that the tinctures of the gum-resins make excellent vehicles for various agents in the treatment of skin diseases.—Med. Record.

PRIMARY EXTIRPATION OF THE ASTRAGALUS IN CASES OF IRREDUCIBLE DISLOCATION.-Weiss strongly advises to perform the operation at once when the bone cannot be reduced. The absence of an external wound is no contraindication, as the mortality, which was estimated at twentyseven per cent. by Broca, has been lessened very materially by the introduction of the antiseptic treatment. In the author's own case (a simple irreducible dislocation outwards, with much inversion of the foot) the operation was difficult, and the wound did not heal for a long time; but after a few months the patient began to walk, and the result appeared to be quite satisfactory.-London Medical Record, March, 1884.-Med. News.

MEDICINE.

ALUM TREATMENT OF WHOOPING-COUGH.-Not may years ago alum was one of the favorite remedies for the relief of pertussis, but of late it has been almost entirely superseded by other less unpalatable drugs. Now it seems to be again entering upon a time of favor and appreciation. Dr. Warfvine, of Stockholm, records a series of cases of pertussis of varying degrees of severity in which he exhibited the remedy, as a rule, as soon as the characteristic symptoms were declared. The earlier the treatment was begun the better were the results obtained. In one case of a boy, eight years of age, who had had a cough for three weeks, and who had just begun to whoop, the symptoms disappeared entirely after the use of alum, in a two per cent. solution, for two weeks. In another case of a girl, six years of age, who had from twenty to twenty-five moderately severe attacks in a day, the cough was cured in ten days by the same means. The remedy was given usually in a one or two per cent. solution, in equal parts of water and orange syrup, in the dose of a teaspoonful four times a day. Even in the later stages of the disease, the attacks seemed to be greatly reduced in frequency and severity when alum was exhibited to the exclusion of all other remedies.-N. Y. Medical Record.

PANCOAST'S COUGH MIXTURE.-The following formula, said to have originated with the late Prof. Pancoast, of Philadelphia, has the advantage of containing no opium or morphine, since many persons cannot take either of these remedies without discomfort. Wild cherry bark, senega, a drachms iv; ipecacuanha, drachms ij; extract of conium, gr. xv; water q. s. ft. (by displacement) fl. ounces viij; then add gin, ounce i; compound tincture of cardamon, ounce j: two teaspoonfuls in water constitute the usual dose to relieve cough.-Med. Bulletin.

a

SUBSTITUTION OF THE SODIUM IODIDE FOR THE POTASSIUm Iodide.Dr. Berg (Archives of Medicine, April, 1884) enters a plea in behalf of the sodium iodide in lieu of its potassic congener. Both from theoretical considerations and practical experience, he urges the substitution of the sodium for the potassium salt. He makes the following claims for the iodide of

sodium:

1. It can be used therapeutically for almost all, certainly the chief purposes for which potassium iodide is used, and, he believes, with similar beneficial effects. 2. Sodium iodide is more assimilable than the iodide of potash, both locally to the digestive organs and to the general system. 3. Many of the local and general undesirable effects which are. produced by the potassium iodide do not follow the use of the sodium iodide. He concludes by saying that it is to be hoped, therefore, that the sodium iodide will be used by those whose clinical advantages admit of an extensive trial of the drug, so that a more extended experience may confirm that which a limited experience would seem to claim for this drug.

PULSATILE PLEURISY -Dr. Comby (Arch. de Medicine) calls attention to the semeiological value of thoracic pulsation in pleurisy. In pleurisies of the left side, there are pulsations synchronous with the beating of the heart. These occupy chiefly the lower part of the thorax, and are sometimes limited to a tumor, which has its seat in the thorax or the lumbar region. These thoracic pulsations are due to the transmissions of the heart-beats across the sclerosed lung to a liquid. They are only met in old purulent pleurisies, with retraction of the lung and fusion of that organ with the pericardium. Every pleurisy of the left side with pulsations, pulsatile empyema, is a purulent pleurisy. Pulsations indicate purulence. They have even a more extended signification; they indicate not only purulence but destruction of the lungs. It is a sign of incurability. Such is the diagnostic and prognostic value of pulsatile empyema.-St. Louis M. & S. Jour.

CAPSICUM, NOT CHLORAL, IN DELIRIUM TREMENS.-In a paper published in the Boston Med. and Surg. Journal, Dr. C. M. Seltzer says: Beef tea, made red-hot with red pepper, is the very best treatment for delirium tremens. A patient to whom I once administered such a dose, made so strong that I would not have dared to taste it myself, afterwards told me that it was the most refreshing and cooling drink he had ever taken. A London surgeon of the police told me that he had treated a hundred and fifty cases of delirium tremens with this remedy alone, and had not lost one. The use of chloral in these cases is criminal, and many a death certificate of "delirium tremens" ought to be "heart failure from chloral poisoning."

IS CANCER INCREASING ?-We have been told frequently of late that cancer is increasing, and becoming more securely planted in our midst; and, if this be so, it is an important fact, but of such terrible significance, that we must needs require the most conclusive evidence. The RegistrarGeneral distinctly says in his last report that the increase is not a genuine increase, but is due to increased accuracy of diagnosis, which is constantly tending to increase the number of deaths registered as due to definite diseases, at the expense of the more indefinite groups. Such a statement, we may assume, would not be put forth without the sanction of Dr. William Ogle, the Superintendent of Statistics, and one of the first of living vital statisticians; we may derive some comfort from this, and may at least suspend our judgment until the publication of the decennial summary of the Registrar-General; indeed, until that is published, the materials for an accurate judgment hardly exist in a form in which they can be easily analyzed. Meanwhile, we may point out one consideration which seems to have been somewhat overlooked. Excluding sarcoma, as we may do without materially affecting the proportion which the figures bear to each other, we may say that cancer is a disease of late maturity and senility; especially is this the case with men. Now, the death-rate from all causes has materially declined, and the average expectation of life is greater at the present time, than it was a quarter of a century ago. Practically, it will be safe to assume that a greater number of people live into the period of maturity and senility, and therefore a greater number live into the age when cancer is prevalent. We might expect, therefore, to find more people dying of cancer at the present time than a quarter of a century ago. There is this further hopeful feature, that a comparison of the ages at which people die now and formerly appears to show that the deaths are taking place now at a more advanced age; the percentage of deaths from cancer above 55 years of age is materially greater than it used to be. Lastly, the number of deaths among men is increasing more rapidly than among women; and about that fact there is this hopeful feature, that, if we take 100 deaths from cancer among men, and 100 among women, we shall find that a far larger number of the male deaths occur after 65 than of the female deaths. About a third of the total mortality from cancer among men occurs after 65, while only a quarter of the total mortality from cancer among women occurs after that age. It would seeem, therefore, that the increase in the deaths from cancer is due, in part, to an increase in the number of people who reach the cancer age, in part to an increase among men at an advanced age, and in part perhaps also to a genuine increase in the grasp of the disease overthe population.-Brit. Med. Jour.