gheny County Medical Society, the patient was examined by a committee, which reported that the aneurism was cured, and that the only evidence of disease at the time was a slight endocardial murmur."-Medical Record.

SICK ROOM VISITATION.

The Country Practitioner makes the following timely remarks on the above subject:

"One of the greatest nuisances against which the country practitioner has to contend is the visitation of sympathizing neighbors to the rooms of his patients. In the country, people are acquainted for miles around, and every case of severe sickness, every confinement, and especially every surgical case, is an object of general interest, either through sympathy or curiosity. It is a difficulty hard to combat, since, excepting obstetrical cases, it is not the custom in the country to employ regular nurses for the sick. Such attendance as the family are unable to give is volunteered by neighbors, and hence the patient is exposed to quizzing, news-telling and medical advice of a new attendant every night. It is wonderful what an amount of medical knowledge the people possess. Each attendant can inform the patient of some positive cure for his ailment, and many times induce him to try the remedy. Very frequently, too, the patient is impressed with the superior qualifications of some medical man other than the regular attendant, and at all times, through these varied accomplishments of his attendants, kept in a condition of nervous unrest that prolongs and exaggerates the case. Again, these nightwatchers generally go in couplets, and in order to keep awake spend the night in gossip regarding the crops, the people, the marriages, the deaths, wonderful cases of disease similar to that of the patient, and, if masculine, even politics. During all this the patient tosses and tumbles in the vain effort to obtain sleep and rest.

"Still another class insist upon visiting the sick out of sympathy. These are the most difficult to manage. Each deems himself or herself a privileged character and must be admitted. In my younger days, when I was afraid of offending pros

pective patients, I have had frequent cases of puerperal fever brought on by half a dozen women gossiping in the lying-in chamber. That time is past, and the visitor that enters such a chamber under my control at the present time never cares to repeat the offense. The whole system of sick-room visiting should be prohibited, no difference what the ailment if it is sufficiently severe to keep the patient in a room. None but the immediate family-and only such of those as are of use— and the necessary attendants (these to be changed as seldom as possible) should be admitted. Rest is admitted by all to be one of the greatest aids to recovery in all kinds of sickness, and of paramount importance in convalescence from labor; I use the word convalescence advisedly, for under no circumstance is the patient a sick woman after natural, uncomplicated labor, unless she is made so by neglect, want of ventilation, want of rest or officious interference on the part of nurse or friends. In conclusion, every physician who values the lives of his patients, or his own reputation, should constitute himself the sergeant-at-arms of the sick room, issue his positive orders and see that they are carried out."

THE TREATMENT OF URÆMIA IN CHILDREN BY PILOCARPINE.

(Medical Record from foreign journal.) From the study of eleven cases, all treated by muriate of pilocarpine, Dr. Praetorius, of Mayence, arrives at the following conclusions: The action of the alkaloid of jaborandi on children may be recognized by active carotid pulsation, reddening of the face, and profuse perspiration, which begins on the forehead, upper lip and chin, and gradually extends over the whole body. These symptoms appear about three to five minutes after hypodermic administration of the drug. Accompanying the diaphoresis a profuse salivary secretion is observable. In infants the sialagogue action is the more reliable of the two. The temperature is affected only in so far as the evaporation from the sweating cutaneous surface produces a slight secondary lowering. The single dose of the drug is 1-32 to The children, as a rule, complain of

of a grain (0.002–0.02). severe nausea, and vomit

ing is frequent. Conditions of slight collapse are sometimes

noticeable. The following resume of inferences is appended to the paper:

1. The treatment of uræmia by hypodermic use of pilocarpine gives satisfactory results. It appears advisable to resort to this plan of treatment as soon as headache, an irregular pulse, and vomiting point to the probability of renal complications.

2. The contraindications for its employment are: The presence of grave complications, abnormal weakness, collapse, or general cutaneous dropsy.

3. It appears that in "glomerular" nephritis pilocarpine fails to produce a beneficial effect. But as this variety of Bright's disease cannot be differentiated from other forms by our present methods of examination, this condition cannot, of course, be classed with the contraindications.

4. In addition to the diaphoretic action of the muriate of pilocarpine, a direct influence on the renal secretion appears to exist.

SURGERY.

TRACHEAL TUBES AS A SUBSTITUTE FOR TRACHEOTOMY.

A singular expedient is proposed by Dr. Macewen in the British Medical Journal (Pacific Med. and Surg. Journal), to take the place of the ordinary operation of opening the trachea. It consists in the introduction of a tube through the mouth. He gives several cases in which he has adopted this measure with good results. He believes that tubes may be passed through the mouth into the trachea, not only in chronic, but in acute affections, such as oedema glottidis, and this, with a little practice, without administering an anæsthetic. The respirations may be carried on perfectly through them, the sputa can be expelled through them, and the deglutition can be carried on while the tube is in its place. Though the patient at first suffers from painful sensations, these soon pass off, and the presence of the tube creates little disturbance, the patient being able to sleep with the tube in situ. The tubes were harmless in the cases he gives, and the ultimate re

sults of the treatment were rapid, complete and satisfactory. Such tubes may be introduced in operations on the face and mouth to prevent blood from running into the trachea, and for the purpose of giving an anesthetic, and answer the purpose admirably.

A NICKLE IN THE PHARYNX DISLODGED AFTER EIGHT YEARS AND TWO MONTHS.

Dr. Singletary reports in the Louisville Medical News the following singular case:

In 1876, I was called to see Mollie Dodson, aged seven years, and found her suffering with broncho-pneumonitis. She is a farmer's daughter, and the family history is good; was born October 13, 1869, and had been healthy and robust till February 26, 1872. At this time, while playing with a nickel she swallowed it. She suffered much. Dr. Reno was called and he treated her through a case of "pneumonia." During that year, she had two other attacks of "pneumonia," and one or two attacks each year after. From the day of the accident, she was delicate, short of breath, could not play much, and had a melancholy appearance generally. She ate very slowly and with great care, for she could not swallow any solid food, such as lean meat, chicken, etc. Nor could she eat dry bread. It was always 'necessary for her to have some fluid when she ate, that her food might be washed down. Her throat was sore during the first year; her stomach irritable, and she vomited often with great difficulty.

More than four years had passed when I first saw her, and it was with much suffering that she recovered from bronchopneumonitis. I then told the parents, that the nickel was lodged, and was the prime cause of all her troubles, and, if they would bring her to my office when she was well, that I would extract it if the surroundings would justify me. At the same time, I told them that she might die when the nicke was dislodged, but if it remained she would surely die of its effects. They could not realize that it was still there, from the fact that four doctors had attended her at times during her many attacks, and not one had claimed that the nickel was

lodged, but, to the contrary, one of them said that it had no connection in any way with her sickness.

On the night of April 27, 1880, she vomited some half gallon of matter, intermixed with "blood and corruption." This was just eight years two months and one day from the accident, and twelve days later (May 9) she passed the nickel per anum. The nickel is quite black and corroded, and yet it presents every feature plainly. It weighs eight grains less than an ordinary nickel, and as it was probably new at that time it may have lost more than eight grains.

Miss Mollie D. is now well, hearty, robust, playful; and can run, play, jump, holloa, talk, eat, etc., the same as other children—a thing that has heretofore been entirely unknown of her. She is improved in growth, weight, color, and voice very much.

I have examined all the records at my command and am unable to find a parallel. I find many cases of foreign bodies in the pharynx and oesophagus, but all of short duration, save one reported in Erichsen, where a man swallowed a piece of gutta percha, and it remained in the gullet a little more than six months and was vomited up, but the man fell down dead.

A NEW METHOD OF OPERATION FOR CONGENITAL PHIMOSIS.

Dr. Demeaux, of Puy l'eveque (Med. Record, from Le Courier Medical) has devised a new and simple method for the operative cure of congenital phimosis, with which he has already had pleasing results. He states that the operation is simple, short, devoid of all danger, unattended by loss of blood and not followed by suppuration. It is described as follows: A strong silk ligature about one foot long is well waxed and provided with two needles, one at its middle, the other at one extremity. A grooved director is now introduced under the prepuce, and pushed as far as the end of the the glans (sometimes not quite so far). The needle fixed at the end of the thread is then introduced along the director, made to pierce the skin at the termination of this instrument, and the thread is then drawn out. Now the second needle, with a double thread, is made to pierce the prepuce at its mid