who work only two or three hours a day, and disappear, as a rule, after a certain time in those who work more.

2. While admitting that excessive labor may and must have an injurious influence upon the stomach, I cannot accuse the sewing machine of those digestive disorders which are met with in Paris in 16 out of 20 women working in all trades.

3. If, as I have done, a comparison be made between the respiratory apparatus in female operators upon the sewing machine and that of women sewing by hand, it is found that certain affections of the respiratory passages, as dyspnoea for example, are met with in the same proportion.

4. The noise made by the machine has been assigned as injurious to the nervous system. This imputation has but little foundation; for if it be true that at first the sound of the machine causes a little malaise, it is also certain from the testimony of the operators that they very soon become accustomed to it, and that it produces no bad effect upon the health.

5. Without stating positively that the sewing machine is not the cause of certain genital excitements, I have been induced to assert that the remarks published upon this subject, and the conclusions deduced therefrom, have no value. In this case too, as I have shown in my work, the evil is rarely the effect of the sewing machine, and I have almost always found the cause of the excitements of which I speak in previous habits, in moral perversion, or in certain physical disorders.

6. A careful investigation has proved to me that female operators are not, as has been pretended, other things being equal, more subject than other working women to metrorrhagia, miscarriage, peritonitis, and leucorrhoea; and that the cases which have been cited are evidently simple coincidences and the result of a labor too severe for the woman's strength.

7. Even if it were shown that certain imputations against the sewing machine have really, in particular cases, some foundation, they would no longer have much importance in these days of the almost general use of steam and other motive agents lately invented, either for the factory or for the operators in the room, and the cost of which is rapidly diminishing.

8. As regards the machines with the women as motive agent, those with isochronous pedals should be preferred to those with alternate pedals; in this way the operator is guarded from any excitation.

9. To recapitulate, we think that the sewing machine with a woman as motive agent, when it is used within reasonable limits and without overworking the operator, as is too often done, has no more ill effects upon the health than has sewing

by hand. As a proof of this, I have been unable, among 28 women from 18 to 40 years of age, working 3 to 4 hours a day, to verify any ill result whatever which could be attributed to the sewing machine.

THE AGE AT WHICH MENSTRUATION COMMENCES. By WAL TER RIGDEN. (London Obstetrical Transactions, Vol. XI., 1870.)

THE following statistics were obtained from women who applied at the University College Hospital, to be attended in their confinement:

In 2,696 cases menstruation occurred for the first time

From these cases it would appear most common at 14 years of age, then 15, 16, 13, 17, 12, 18, 19, 20, 10.

The mean age in these cases is 14.96 years nearly.

ON THE TREATMENT OF INCONTINENCE OF URINE IN CHILDHOOD AND YOUTH BY COLLODION. By Sir D. J. CORRIGAN, Bart., Physician in Ordinary to the Queen in Ireland. (Dub. Quar. Jour. Med. Sciences, Feb., 1870.)

LONG since I tried to close the opening of the prepuce with adhesive plaster, or court plaster, and in one case, that of a young man of twenty years of age, who had entered the army, and who was intelligent and careful, the result was favorable, but there were great difficulties about it. The application took time, and could not be carried into successful effect with boys and children.

The mechanical treatment to which I now wish to draw attention is the treatment by collodion. It is most easy of application, occupies scarcely a minute, and can be carried out at school, college, or elsewhere, in perfect privacy.

All that is necessary is, while the prepuce slightly curved up is held with the left hand, to smear over the little cup thus

formed by the extremity of the prepuce with collodion by means of a small camel's hair pencil or blunt end of a penholder. Almost as fast as applied the collodion solidifies. In contracting it draws closely together the edges of the prepuce, and thus the exit for the escaping urine is closed.

A boy of eleven years of age has, after one lesson, been able to use the collodion, and has used it every night carefully and diligently, so anxious has he been to cure himself of what he considered a disgrace. A fortnight's use is sometimes sufficient for the cure. A relapse is easily dealt with. A solution of gutta-percha in chloroform would seem at first sight to be equally applicable, but it is not. The solution of gutta-percha is much longer in hardening, and it possesses no contractile powers.

When the child or youth desires to pass water the little wedge or cap of collodion is easily removed with the finger nail.

When I first used this collodion application, my expectation was that the bladder would act so forcibly against it as to cause sudden pain, and oblige the patient to jump at once out of bed and quickly remove the collodion, and that he should then repeat the application before returning to sleep.

I was agreeably disappointed. There was no pain; no awaking; but on rising in the morning the prepuce was found slightly distended with urine, and the collodion was removed without difficulty.

This unexpected result would lead us to infer that the action of the muscular contractile fibres of the bladder has little to do in causing the noctural incontinence of urine in childhood, and that the escape of the fluid is rather due to want of opposition in the sides of the canal of the urethra, or to a feeble state of the circular fibres which are supposed to constitute the sphincter of the neck of the bladder.

Acting on this view I have recommended the child's bed to be made in such form as that, while preserving the usual slope for head and shoulder, the rest of the bed shall gently rise as an inclined plane, from hips to feet, so as to allow the urine in the bladder to gravitate towards the fundus, rather than towards the trigone.

In all the instances in which I have used the collodion application the prepuce has been, as I believe is nearly always the case in children and boys, projecting over the glans, or in a state that may be designated as natural phymosis. But I do not anticipate any difficulty in using the same application in cases where the corona glandis might be exposed, as the collodion

would, I should expect, act equally well over the orifice of the urethra as over the opening in the prepuce.

It may be presumption, but I cannot conclude without expressing a strong opinion against one part of the management of these cases, which is very frequently practised through the best motives on the part of mothers and nurses, and sanctioned by the recommendations of some medical authorities-the practice of awaking the child at stated intervals to pass urine.

I have never seen any benefit whatever from it, and I think I have, on the contrary, always seen aggravation of the affection from it, not unreasonably to be explained, on the principle that such practice is really training the bladder to empty itself at stated periods, when the object is that it should be trained to retain its contents.

ON THE TREATMENT OF COMMENCING CHRONIC DIARRHEA IN YOUNG CHILDREN. By EUSTACE SMITH, M.D. Physician Extraordinary to H. M. the King of the Belgians; Physician to the North-West London Free Dispensary for Sick Children, etc. (European Practitioner, July, 1870.)

CHRONIC diarrhoea in young children, a simple functional derangement which becomes confirmed, is always a serious and often a fatal disease. It usually begins very insidiously, and not unfrequently results from a slight chill or a meal of improper food, which excites a little irritation of the stomach and bowels. This irritation, when once set up, is easily maintained by causes the same in kind, although less in degree, than those which originally provoked it, and a chronic catarrh is induced, which becomes less and less amenable to treatment the longer it continues.

A child of a year or eighteen months old is exposed to cold, and shortly afterwards the bowels become slightly relaxed. The purging is, however, neither severe nor of long continuance; it speedily ceases, and the child appears to have recovered. The bowels, however, do not return to a healthy condition. There is no diarrhoea in fact; complaints are made that the bowels are not sufficiently open. For a day or two they are not relieved at all; then, on the third day, the child has two or more large sour pasty-looking motions, more or less slimy from the mucus with which they are mingled, and passed with considerable straining efforts and much apparent discomfort. This state of things continues for weeks. The child gets a little pale, but if able to walk, still keeps on his feet. He is occasionally sick, vomiting sour-smelling food, with sometimes a little bile, and

his breath often smells sour and offensive. The appetite is all this time usually unimpaired; he may occasionally refuse his food for a day or two, but his appetite soon returns, and with the exception of an occasional attack of diarrhoea lasting for one or two days, the bowels remain irregular, the stools, when they occur, being large, pale, pasty, and sour-smelling, consisting evidently undigested food, mixed with a little fecal matter and a considerable quantity of mucus. With the exception of gradual loss of flesh, color, and spirits, there is nothing very positive in the condition of the child by which the attention can be arrested.

After some weeks, or even months, during which he has got thinner and paler, without any change in his general state, the child is seized with an attack of purging, which does not, as has been usual, pass away. On the contrary it becomes more severe, and the stools increase in number and in quantity. The child now loses flesh rapidly; he is taken altogether off his feet, and his state becomes one of great danger.

These cases are often looked upon as instances of disease of the mesenteric glands, but the most careful examination of the belly will seldom furnish any satisfactory evidence of glandular enlargement. The temperature is lower than in health, and seldom rises higher than 98° Fahr. in the rectum. There is no particular desire for drink. The child is a little restless at night; he takes his food with considerable appetite, and even sometimes with voracity: the food, however, does not nourish him, and appears hardly changed in the stools.

These cases, obstinate as they prove when not treated judiciously, will yet yield quickly to suitable measures; and unless the weakness and emaciation are very great do not as a rule present any great difficulty in their management.

The object of the present paper is to describe the method of treatment applicable to these cases during the period, often sufficiently extended, before the diarrhoea has become confirmed; when the child is becoming more and more listless and pale, is losing flesh and strength, while his motions, infrequent but copious, exhibit the characters which have been described above.

The presence of undigested food in the motions of a young child, especially if that child exhibits evident marks of deficient nutrition, is a sign that the diet is an unsuitable one and requires alteration. Whether the digestive weakness be a simple functional derangement, or be due to the existence of organic disease, in either case our object is the same-viz., to adapt the child's diet to his powers of digestion, so that the food he swal