experience I can confidently affirm that none of the accidents and inconveniences which so commonly attend the administration of podophyllin ever arise when the drug is prescribed according to my method. On the contrary, it is one of the most satisfactory and reliable of our medicines. The formula given is:

Podophylli, gr. ij.

Essentiæ zingiberis, 3 ij.

Spiritus vini recti q. s. ad. 3 ij.
Fiant guttæ.

A teaspoonful to be taken in a wineglassful of water every night at bedtime, or every second, third or fourth night as required.-Dr. Horace Dobell, Brit. Med. Jour.

SURGERY.

SULPHIDE OF CALCIUM IN THE TREATMENT OF SUPPURATING BUBOES.

Ringer, in his work on Therapeutics, seventh edition, page 123, says:

"This group of remedies (sulphides of potassium, sodium, ammonium and calcium) influences the suppurative process in a marked and manifest manner. Thus, the common case of a sore, discharging a thin, watery, unhealthy ichor, will speedily undergo a healthy change under the administration of sulphide of calcium, the discharge becoming at first more abundant, afterward diminishing, and throughout continuing thicker and healthier, with all the characters, indeed, of "laudable" pus.

"The sulphides appear to us to possess the property of preventing and arresting suppuration. Thus, in inflammation threatening to end in suppuration, they reduce the inflammation and avert the formation of pus. * * * * After the formation of pus, the influence of this group on the suppuration is still more conspicuous; then the sulphides hasten maturation considerably, whilst, at the same time, they diminish and circumscribe the inflammation, promote the passage of pus to the surface, and the evacuation of the abscess."

Ringer goes on to state the wonderful efficacy of sulphide of calcium in abscesses about the neck, mammary abscesses, boils and carbuncles. He found the remedy less useful, however, in forwarding the maturation and expulsion of pus in indolent buboes, but states that his experience in such cases had been small.

Fessenden N. Otis, M. D. (New York Medical Journal), reports remarkable success with this remedy in the treatment of inguinal buboes, associated with chancroid. The suppuration of such buboes has been considered inevitable. Of eighteen consecutive cases of inflammatory bubo, occurring with or as the immediate sequel of well-pronounced chancroid, resolution occurred in fifteen, and in only three was incision ultimately required. Results like this must establish sulphide of calcium as a remedy of wonderful efficacy.

SPECULAR EXAMINATION OF THE RECTUM.

rectum, is incomused in the same

Sims' speculum, for examination of the parably superior to all others. It is to be manner as for vaginal examinations, with the patient in Sims' lateral, or, accurately speaking, latero-prone position, and, when used in this way, it gives as good an exposition of the rectum as of the vagina. Its use is much facilitated by forcible dilatation of the anus by the method of Van Buren, but unless the dilatation is indicated as a part of the patient's treatment, this may usually be omitted. Applications to the rectum may be made through this speculum with as much ease as to the vagina or uterus. The operation for internal hemorrhoids, also, is much facilitated. When the operation to be performed is very far above the anus, the walls of the rectum may, by contact with one another, cause annoyance. This difficulty may be overcome by a device of Dr. A. J. Stone, of St. Paul, Minn. Dr. Stone attaches to a soft-rubber tube, armed with a stylet, a rubber bulb with very thin and flaccid walls, in such a manner that by blowing through the tube the bulb may be inflated. The speculum is first to be introduced. The collapsed bulb is then to be pushed by the stylet above the place of operation, inflated by blowing through the tube, and

retained in place by slipping the tube, the stylet remaining in place back of the speculum, where it will be entirely out of the operator's way. All that part of the rectum below the inflated bulb will then be distended and accessible.-Chicago Medical Gazette.

OBLIQUE SECTION OF THE SKIN IN SURGICAL OPERATIONS.

From various sources, the attention of surgeons is being called to the advantages of oblique over vertical sections of the skin in surgical operations. In a paper read before the New York Academy of Medicine, May 6, 1880, Dr. John H. Packard recommends this method in nearly all the cutting operations of surgery, except where it is the purpose to establish artificial openings. The advantages claimed are: 1. A close apposition of very wide surfaces with exclusion of air from the cavity of the wound, by means of a strictly valvular arrangement—the position of the edges being favored by atmospheric pressure.

2. The avoidance of unnecessary scarring. It is claimed that there is much less suppuration, and more prompt and firm union of cut surfaces.

CUPPING IN CARBUNCLE.

Dr. Hunt writes to the Chicago Medical Journal: In the early period of my practice, some forty years ago, I used the cups in the treatment of local diseases more frequently than now. During this period, I had to treat a bad case of carbuncle, situated on the back of the neck of an old man. While dressing it one day, it struck me forcibly that cupping would be just the treatment for this case. Calling for a large goblet and some cotton, I applied it as a cup, after expanding the air by burning cotton in it. The effects were truly wonderful, drawing out from the interior of the tumor a large amount of pus and corruption, which gave immediate relief. The night following, the old gentleman rested for the first time. Since this experiment-the first one of which I ever heard or knew I have relied mainly on the cups for the local treatment of carbuncle. It fulfills the most important indications in the local treatment of this often troublesome and sometimes

dangerous disease. It relieves tension and pain, and limits gangrene of the cellular tissue. It materially shortens the time of cure. With appropriate general treatment, the disease is shorn of half its pain, duration and danger. The cups may be applied once or twice a day, or even oftener. If resorted to in the early stage, the scalpel or lancet should be used to induce a free flow of blood. Mere dry cupping at this time would increase the flow of blood to the tumor without relief. I would caution against too severe cupping until pus is formed; I more often use a large, blunt-rimmed tumbler or goblet than any other kind of cup. The size of the opening of the cup should be, if possible, sufficiently large to cover the base of the tumor. An air-pump attached to the cup, if at hand, would be much more manageable and convenient; but the tumbler and cotton may be used with almost equally good effect, if adroitly done, besides having this advantageof being always available.

THE TREATMENT OF EMPYEMA BY SIMPLE INCISION.

Dr. Martin Burke, in the Medical Record, recommends this method in preference to more complicated operations. He cites two cases as follows:

One was a girl of ten years of age, who was brought to the office with a temperature of 1041°, and a pulse of 120. She was operated upon in the office. We first gave her a good drink of brandy, and then made an incision in the axilla a little superior and anterior to the lower angle of the scapula. I next inserted a drainage-tube eight inches into the pleural cavity, leaving some four inches outside. I packed oakum over the tube after fastening it in place. The tube fenestrated. Now, what I want to point out is this, that, even if the air does rush in and out when the oakum is removed, it does not do so when it is in place; and I hold that, in my experience, a valvular tube and two counter-incisions are not necessary to insure a cure, and that without deformity of the chest-wall on the affected side. The little girl was operated upon three months ago, the tube is nearly all forced out by the pleural surfaces uniting, and on measuring the chest, I find that there

is only half an inch of difference between the two sides. I hope to correct this by suitable exercise. My other case was that of a gentleman who was cured before I read Dr. Phelps's article, and he is not now in New York; but he had no perceptible deformity, nor am I afraid of any bad result in the future. To conclude then, I think anything which renders this operation more complicated deters the profession from performing it, and loss of life results. I am sure that my results are as perfect as any one could have, and no apparatus are required save oakum, a drainage-tube, and a sharp-pointed bistoury. I think an opening large enough to admit the forefinger all that is required. I do not write this for the purpose of controversy, nor will I explain why I think the oakum acts as a suitable valve, but leave all this to any one who chances to read this letter.

REPRODUCTION OF BONE.

Surgeon George F. Shrady, in the Medical Record, reports a remarkable reproduction of the shaft of the humerus, after excision for acute necrosis. The patient was a newsboy, fifteen years old. The shaft of the humerus was removed from its separation from the upper epiphysis to within half an inch of the lower epiphysis. New bone commenced forming at once, and the osseous deposit increased so that, at the end of nine weeks, the humerus was firm enough throughout its whole extent to allow the patient to sit up and support the arm by the elbow while the wounds were being dressed. The new humerus is half an inch shorter than the same bone on the opposite side, and is of an irregular cylindrical shape, the center of the shaft being somewhat enlarged. The strength and firmness of the new bone is fully equal to that of the other

arm.

TREATMENT OF PROLAPSE OF THE RECTUM AND OF HEMORRHOIDS BY INJECTIONS OF ERGOTINE.

At the recent meeting of the Societe de Therapeutique, MM. Ferrand and Vedal raised an interesting and important discussion on the treatment of hemorrhoidal and rectal prolapse. The case of a patient treated by M. Ferrand was reported, in which all the ordinary means of cure had failed.