ished, should be three inches in length. A little practice will enable any one to make them very nicely.

The manner of using them is very simple. The speculum being introduced in the usual position, the cervix drawn down by the tenaculum, the cervical canal wiped dry with a pledget of cotton, and the tent introduced to the fundus with the depressing forceps, the tent being first prepared by attaching a cord a foot long to the large end, in the middle of which (cord) is tied a tampon of cotton as large as a large walnut; the tent is then saturated with the medicine desired, after which it is slightly oiled to facilitate introduction. After being placed in the uterus, the vagina should be syringed with a little tepid water to prevent the medicine from attacking the vaginal mucous membrane, and thus producing pain. The tampon of cotton is then placed in contact with the os and held in place while the speculum is slowly removed—the end of the cord protruding between the labia, so that the patient may remove it any time she may desire to by making traction on the cord. I make the application, if possible, in the afternoon or evening, and the patient removes it on rising the next morning, keeping moderately quiet during the time of wearing it. I repeat the application from one to three times per week, according to the severity of the case and strength of medicines used.

I use the iodine full strength tincture, and the carbolic acid one-tenth dilution, for ordinary cases, but do not hesitate to use the pure crystals in a severe case.

MENORRHAGIA.

Ergot and Sulphuric Acid.-(Braithwaite's Retrospect.)— Of all the medicines.with which I am familiar-and I have tried a great number ergot stands first. In obstetrics you are generally told that ergot produces its effect in about fifteen minutes; that is doubtful even in parturition; but in the unimpregnated woman you must not expect it to act thoroughly till days of its use have elapsed, and in some cases I have observed its use has had no result until it has been continued for weeks without intermission. After ergot, in popular estima

tion, come gallic and tannic acids. I am not quite sure that they have any effect at all. They may have an effect, and be as rationally used as other medicines. I have used them extensively, and the impression they have left on my mind I have just told you. The medicine which seems to me next best after ergot of rye, is sulphuric acid, often combined with some saline; and no injury is done if the saline produces slight relaxation of the bowels. You have not long to wait for sulphuric acid to produce its effect. You may have to give it in large doses, and frequently; for instance, you may give one drachm, or even twice as much, in a day, dividing it into frequent doses. The beneficial influence of digitalis and cannabis indica is almost certain, yet in point of reliability these remedies come considerably after egot and sulphuric acid.

TREATMENT OF AMENORRHEA.

Of all remedies (Medical Bulletin, New York Medical Abstract) none stand so high in value as electricity properly applied. Whilst it is true that success invariably follows the intelligent use of this therapeutic agent, it is equally certain that many failures have occurred under a careless employment of it. The most difficult cases which have fallen under my care have been of this kind, and considerable effort has usually been needed to overcome the natural prejudice of the patient against what seemed a waste of time and money alike when electrical treatment was again proposed. Take as an illustration: Miss D. contracted a light bronchitis, followed by a menstrual suppression. The catarrhal difficulty was looked on as important, and had medical advice promptly. When better of that, inquiry was made as to the amenorrhoea, but the matter was left by the family attendant's direction to nature for three months without effect. No improvement being manifest, she was treated by him with a variety of emmenagogues unsuccessfully for the ensuing three months, the latter two weeks including weekly so-called electrical "seances," which were conducted by applying one pole over the abdomen, and the other was held in either hand. After failing of relief, she did nothing for six weeks, and then consulted me at the suggestion of a friend.

I began two weeks before her expected term with faradie currents applied diversely through the uterus by my usual method, one rheophore being introduced into the cervical canal, and the other through a bifurcated conductor to the two ovarian regions. Six sittings were had of this nature, and on the evening before her term, galvanism was substituted. She was unwell next morning and menstruated without discomfort. She kept well for two months, and, catching cold, she missed once more. One faradic application each week three times, and two of galvanism the week before, brought on her sickness promptly, and without discomfort. She has since remained well.

Miss W., after treatment by three physicians for eleven months, called on me, and showing nothing beyond amenorrhoea, was placed on faradic and galvanic measures, as above detailed. After sixteen applications, the flow was established, and has since been normal in every respect.

Equally good results have followed in suppression from change of climate, as referred to above. So certain is the relief that unless other indications demand it, no other treatment is employed. The constipation, which is a common accompaniment, gives way readily under electric treatment without assistance.

HYDRATE OF CHLORAL IN TREATMENT OF PUERPERAL CON

VULSIONS.

In puerperal eclampsia (New York Medical Abstract and Louisville Medical News), if the patient can swallow, I give thirty grains of chloral by the mouth, and twenty grains more in an hour if the convulsion returns; or, if she is unconscious, as is most generally the case, I administer sixty grains per rectum, and repeat the same dose in two hours if necessary. Usually a drachm used in this way is all that is necessary to prevent a return of the spasm, and to induce a natural and refreshing sleep, from which the patient will awake in five or six hours perfectly rational and safe, and surprised to hear that her labor is over. I use an ounce of sweet milk as a vehicle for the chloral, and inject it into the bowel with a Davidson, Mattison or any other ordinary syringe.

Case 1.—Mrs. B., age nineteen, primipara, in May, 1878, after an ordinary labor of several hours, with the os fully dilated, was seized with a terrible convulsion. As soon as I could procure it (in ten minutes probably), I threw into the rectum one drachm of chloral, sent for the forceps, and delivered her at once. The spasm returning, I repeated the dose, the patient soon fell into a quiet sleep, which lasted six or eight hours, when she awoke to consciousness and safety.

Case 2.—Mrs. S., age eighteen, primipara, in August, 1879, three hours after delivery by midwife, was attacked by convulsions, which recurred every thirty minutes, and increased in severity with each recurrence for four hours, when I was called to see her. I gave her at once sixty grains of hydrate of chloral by the rectum. Three hours afterward she had another light seizure. She was then given twenty grains by the mouth, after which she slept for six hours, and upon waking, expressed great surprise that she was a mother.

Case 3.-Mrs. B., age twenty, primipara, in July, 1880, eight hours after an easy and natural delivery by my friend, Dr. Cannon, was seized by an eclamptic fit. We saw her together about an hour afterward, and found her unconscious, with stridulous breathing. We administered per rectum the "regulation" dose-sixty grains of chloral. There was no return of the spasm, and the patient did well.

I wish to say in conclusion, that while I regard chloral as one of our most active and certain remedies, I consider its range of applicability very limited.

TREATMENT OF INFANTILE DIARRHEA BY POWDERED

CHARCOAL.

Dr. Guerin, in referring to a recent communication to the Academie de Medecine, made by Bouchardat, remarks that for a long time he has been in the habit of combating infantile diarrhoea by mixing the milk in the suckling-bottle with charcoal powder. He usually adds half a teaspoonful of the powder to one bottle of the milk. The infants take the milk readily, and in a few days the greenish stools of the little patient change to a dark yellow, while their consistence be

comes increased. In addition to the admixture of powdered charcoal, the milk is diluted by one-half or one-third of its bulk of sugared water. He has frequently seen intractable summer complaints yield in a few days to this treatment.Medical Record.

SURGERY.

THE ADVANTAGES OF CAUSTICS FOR THE REMOVAL OF MALIGTM NANT GROWTHS.

Francis M. Stewart, M. D., in the Annals of Anatomy and Surgery: I am glad the attention of the Anatomical and Surgical Society has been called to this subject, and that this mode of treatment has been so strikingly illustrated by the case of Dr. Eltinge, he himself being the patient. The use of caustics for the removal of morbid growths has been neglected by the profession in general, being looked upon as savoring of quackery. I suppose this is because persons ignorant of anatomy, as well as of pathology, except in its dire results, have flourished as quacks-removing such growths with certainty, and often with good results, by means of caustic pastes. Dread of the knife is the universal feeling. We shrink from the mutilation of the body as well as shrink from the pain inflicted by the surgeon's knife. Happily the pain is not now to be endured. An anæsthetic certainty puts the sufferer beyond that, and also the sickening sight of the paraphernalia of the operating room, so often unnecessarily displayed.

It is for these reasons that patients desert the offices of the studious and learned surgeons, and flock to the houses of the 66 cancer doctor." The latter applies a "paste," which he hardly knows more of than its effects, having previously extorted a princely fee from his unfortunate victim. The diagnosis of the disease and the necessity for its removal has already been determined by the family surgeon (?). Perhaps the day has been fixed for an operation, to which the patient has looked forward with feelings scarcely less harrowed than if it were a day of execution. A friendly acquaintance tells of the bloodless and knifeless method of " Dr. " and thither the pa

tient resorts.