that obtained by the forceps in the hands of Crede himself, who reports sixteen cases, of which four, or twenty-five per cent., were stillborn. In view, therefore, of the comparatively good results achieved, the wish expressed by Martin that the profession may at least deem this method worthy of trial will probably be gratified.-Med. News.

SHOULD THE HEALTHY CHILDREN IN A FAMILY WHERE MEASLES IS PRESENT be kept from SCHOOL?-Dr. H. Wasserfuhr in the Berlin Klin. Wochenschrift answers this question in the negative. He thinks that the enforced idleness of four or six weeks is injurious; that the spreading of measles by a healthy child, though possible, is a very unlikely event; that practically, a regulation excluding such persons cannot be enforced, and that measles is a very mild affection if it attacks children in the school years. This view is one generally adopted, we believe, by sanitary officers in this country.-Med. Record.

TREATMENT OF THREAD-WORMS IN CHILDREN.-(Sidney Martin, M. D., M. R. C. P., in Practitioner.) The complete cure of threadworms in children is often very difficult. While the ordinary methods used, such as rectal injections of salt and water, infusion of quassia, and other remedies, do good for a time, yet they often fail to relieve the attendant symptoms of "worms," symptoms usually very irregular, and in some cases severe, in character. In many cases, though the irritation about the anus is relieved by injections, the irregularity of the bowels and the disturbance of sleep remain the same. This is probably due to the fact that the habitat of the worms is higher up in the large intestine, where no remedy introduced by the rectum can reach them.

In many cases I have found that rhubarb in small doses brings away large numbers of worms, and at the same time regulates the bowels: so that the use of injections may in most cases be dispensed with. The formula which I have found most useful is as follows, varying slightly with the age of the child.

R Tinct. rhei m iij; magnesii carb. gr. iij; tinct. zingib. m. j; aq. ad 3 j.

This is to be taken twice or three times daily according to the effect on the bowels. Whether the rhubaab acts as a vermicide or simply by 'moving the worms on," I am unable to say.

URINARY INCONTINENCE OF CHILDREN TREATED BY ANODYNES PER RECTUM.-Morphine alone relieves for the time being, but does not cure.

Belladonna and atropine are curative, when continued long enough, though they are better borne in combination with a little morphine, which counteracts some of their bad effects, and enables them to be given more continuously. Furthermore, the requisite dose of belladonna is smaller when combined with morphine. When these medicines produce headache or undue nervous excitability, I use the bromides as a corrective, or suspend their administration for a time. I have found no case where they could not be borne when properly given.

As to the mode of administration, a fifteen grain suppository of cocoa butter is most easily handled. They should contain a proper amount of extract of belladonna and morphine. For a child five years old, say, one-eighth of a grain of belladonna extract, and one-sixteenth grain of morphine; but the dose must be carefully adapted to the particular case in hand, beginning with a small dose, with a smaller relative proportion of belladonna, and increasing the latter and diminishing the morphine as toleration becomes established.

If an enema or clyster be preferred, it should consist of about a drachm of lukewarm water, with a few drops of atropia and morphine solution added.

As an illustration of this mode of treatment, a bright and charming pretty girl of fourteen came under my care for this disease July 9th, 1883. Had been subject to it for years, in fact nearly all her life. Was of a peculiarly sensitive nervous temperament, and subject to convulsions in infancy and early childhood, for which I had myself attended her. Was just beginning to menstruate. The urinary trouble had become a great source of mortification to her, and her shyness about it was great. I began with morphine alone, one-sixth of a grain nightly, in suppository. Failing to produce full relief I doubled the strength, making onethird of a grain, when she went nearly a month without once wetting the bed. On stopping the suppository the trouble quickly returned. Recommended the one-third grain suppository on September 14th, with full relief of the incontinence as before, but the patient, who was attending school all the time, began to get "fidgety" and nervous from the effects of the morphine, so that I was compelled to give small doses of bromide of potassium daily. This relieved the nervous symptoms entirely. I then began to taper-off on the morphine, giving a suppository every second or third night instead of every night. On this treatment she began to wet more frequently, and I became satisfied that morphine alone would not cure her. October 29th I prescribed a suppository containing one

sixth grain of morphine and one-fourth grain extract of belladonna. On December 10th I made it one-eighth grain morphine and one-half grain extract of belladonna. Both these answered perfectly, and in six weeks she was practically cured. In the succeeding six months she did not wet more than six times, but each time was carefully followed by the use of the belladonna suppository for one week to prevent a relapse. For two years now, since the summer of 1834, she has been perfectly well and improved greatly in general health.

I might report other cases far more rapidly cured. I select the above on account of its long standing, and since I was obliged to proceed somewhat tentatively, as showing very well the comparative action of morphine and belladonna. The latter I have never given without some morphine, believing they act better in combination, as they do when given by the mouth. From present experience I believe the rectal treat

ment to be better than all others.

THE VARIOUS FORMS OF ECZEMA IN CHILDREN.-Professor Grancher. (Journal de Medecine.) Here we have four little eczema patients presenting very different appearances. The first has a simple impetiginous eczema of the face which appeared quite recently and which, despite its apparent severity, will disappear quite rapidly. It amounts to very little. The second case (aged 7) is more complex. The affection commenced when the child was five months old, and appeared upon the cheeks and eyelids. It has since continued almost constantly. The child has had for years the appearance of wearing a sort of dripping mask. She formerly contracted varicella, a complication which made the case a very interesting one. It was observed that the eruption of the varicella was much more confluent upon the parts originally attacked by eczema than elsewhere. During convalescence from varicella, the child's eczema greatly improved. It then contracted a light form of whooping cough, followed by severe diphtheritic angina, and, following these affections, the eczema completely disappeared.

In a third case, a child of twelve, the eczema was symmetrical, chronic and relapsing. The first attacks (at one year of age) lasted for a month or two, and occurred oftener as the child grew older. In the intervals of attack, the apparent cure seemed almost complete. The eczema, which was almost dry, commenced in the face, whence it spread to the arms and legs. Its character was pruriginous. During the child's stay at the hospital it was taken with a chill and an angina pre

ceding scarlatina. Before the eruption appeared the eczema suddenly took its departure. The scarlatina rash was very abundant and was strongly marked on the eczematous regions. The pruritus disappeared for ten days, and then the eczema returned with all of its former symptoms.

Another patient, who had been attacked three times before with eczema, followed by a scarlatiniform desquamation, came to the hospital with an acute attack, accompanied by intense fever which gave way rapidly to treatment. These four cases, so different, yet all of them attribeczema," show how difficult it is to fix upon the true characteristics of the malady.

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A Guiana gentleman consulted the greater part of European dermatologists for an eczema of long standing which covered his face with a veritable mask of vesico-pustules, and had extended to his arm. Various methods of treatment brought no relief. Certain topical applications ameliorated the condition of the arm to a certain degree, but the facial eruption remained stationary. Cod liver oil was prescribed, and the patient was soon able to take twelve teaspoonfuls a day. A month later there was a considerable amelioration of the trouble, and two months afterward the cure was complete. The patient has continued well for a long time, and compensates for the defect in his nutrition by taking a certain quantity of cod liver oil from time to time. The interest of the case centers wholly in the fact that it was cured by internal nutritive medication, and it is impossible not to see in it a demonstration that skin diseases are not local maladies so often as is supposed. Most of them are referable to a defect in nutrition and get well when that defect is remedied.-Medical Abstract.

BELLADONNA IN STERILITY OF FEMALES.-(J. Harris Jones in New York Med. Journal.)—There are few drugs which exhibit so pronounced a predilection to act upon certain structures of the body as belladonna. Among its favorite tissues, those of the female sexual organs may be mentioned. Its employment is followed by more or less benefit in every disease to which these parts are liable. I suppose it has fallen to the lot of almost every practitioner to be consulted by married women who were never pregnant as to the cause of their barrenness. Apparently they enjoy the best of health, and have never suffered from any irregularity of the sexual apparatus. To such I have on several occasions prescribed belladonna internally, and have found that, after taking the medicine for

some weeks, they become pregnant. I have seen this happen so often that I am constrained to regard the occurrence as something more than accidental. I shall not venture to theorize upon its action, but will merely mention that I have observed that the external genitalia become more relaxed, and the os and cervix uteri somewhat softened and pliable, during the treatment.

STERILITY AND OBESITY.-Dr. A. Brondel writes in the Bulletin General de Therapeutique that he was consulted by a married lady on account of sterility, which caused her great unhappiness. The lady was excessively corpulent, so much so that the nurse was obliged to lift up the fat on the mons veneris with both hands before a speculum could be introduced. The genital organs were healthy. The patient was placed on a spare diet in order to reduce her obesity, and persevered in the regimen ordered for eighteen months, at the end of which time she had lost forty-four pounds in weight. The menses, which had formerly been irregular, returned, and the patient soon after became pregnant.

THE AMOUNT OF PRESSURE Exercised UPON THE FETAL HEAD BY THE FORCEPS DURING TRACTION.-The pressure upon the fetal head consists of three factors: (1) The "active" compression made by the hand of the accoucheur, while locking the handles; (2) the "tractioncompression," exercised by the forceps as the result of the traction; (3) the "passive" compression, effected by the pelvic walls. During the act of traction the pressure, as expressed mathematically, is directly proportional to the resistance offered by the head, and inversely as the friction and extent of the surfaces in contact. The power exerted by the hand of the accoucheur is inversely as the cosine of the angle between the blades, directly as the breadth and inversely as the length of the handles. The practical corollary is this—that it is desirable to increase the extent of the surfaces which are in direct contact with the fetal head; the ideal forceps should have short parallel blades and long handles.New York Medical Journal.