the ambulant cases, in whom no anaesthetic was used, there was a surprisingly complete absence of pain during the application of the superheated steam. For several days later many complained of vague pelvic pains, which usually disappeared entirely. In all cases a free leucorrhoeal discharge, sometimes blood-tinged, made its appearance, generally ceasing completely after a time. The writer is convinced after a year's conscientious trial, that vaporization is a useful addition to our present means of combating uterine hemorrhages. A careful diagnosis must be made in every case as far as possible. The uterus must be thoroughly curetted of placental and membranous debris before the vaporizer is employed, and a case of carcinoma uteri must not be allowed to progress, while trying to check irregular bleeding. With these provisions, he believed in the efficacy of superheated steam in controlling, regulating, and checking certain forms of uterine hemorrhage. Although continental writers refer constantly to the danger of cervical stenosis after the use of vaporization, Brothers has met with only one case of distinct obliteration of the external os. He attributes his good fortune in a measure to the fact of using three precautions: 1, thorough dilatation of the cervix with his four-branch dilator; 2, limitation of the application to a period of time varying between five and twenty seconds, unless deciding upon the obliteration of the uterine canal; 3, the introduction of gauze into the uterine interior at the completion of the operation. In many cases vaporization of the uterine cavity was carried on in conjunction with other operative procedures such as plastic work on the cervix and perineum, anterior and posterior colporrhaphy, removal of diseased appendages, Alexander's operation, etc. He agrees with Duehrssen that vaporization should be considered an operation, which implies proper surroundings ffcient assistance, and surgical asepsis. Anaesthesia is preferable, but may or may not be employed according to the patient's wishes. Still Another Tuberculin. The telegraph announces that "a Chicago physician has discovered a tuberculin that will cure (sic) consumption. It is a serum which, he says, will reveal the presence of tuberculosis before it can possibly be detected by the use of the ordinary means used by physicians."-Medical Record. Hospital Notes. CALIFORNIA EYE AND EAR HOSPITAL. By DR. REDMOND W. PAYNE, Surgeon to the Hospital; Professor of Clinical Ophthalmology, Otology and A Bit of Nasal Surgery.-Abbott Anderson reports in the Lancet the case of a cook who, in sharpening a knife, cut off the tip of his nose. After a search the missing piece—an inch in length and half an inch in breadth—was found. It was washed in warm boracic acid and then stitched on with fine silk, after having been severed for thirty-five minutes. The nose was then kept covered for four hours with compresses of hot boracio acid and later with a thick dry compress. The wound healed per primam. Hartwig (N. Y. Med. Neus) reports the case of a six year old boy, to whom, in looking through a broken window-pane, the same accident occurred. The tip fell into the cellar, was looked for, found, washed and restored to its place after a lapse of at least twenty minutes. It was then covered with a thin layer of cotton dipped in aristol collodion and healed on per primam. For a few years the tip of the nose remained red and then reassumed its natural color. In this connection it may be well to recall the fact that the severing of the tip of the nose (as well as the upper part of the ear) is a not infrequent occurrence in German duels, and that the treatment is similar to that just described, and generally as successful. ROBT. D. COHN. Absorption of Uncomplicated Immature Cataract.-When we consider that the opacity of the lens is due to local conditions in the eye itself, dependent upon systemic causes, and that senility is only a predisposing cause, we can well endeavor to stop such causes and thus arrest the process going on in the lens, and in some instances expect absorption to take place. Kalish reports one hundred and thirty (130) cataract eyes, in which he followed this plan, employing what he calls conjoined manipulation and instillation; that it failed in only twelve cases. It is a plan that certainly deserves extended trial, in view of the principles involved in the production of cataract, namely: 1. Fluids containing perverted aliments resulting from defective metabolism supplied to the lens through its nutritive stream. This may be considered a direct exciting cause. 2. Deficient blood supply, thus reducing the quantity furnished, is a contributing cause. The conclusions of Kalish are these: 1. Immature cataract may be regarded as a largely preventible disease. 2. It may, by properly directed treatment, local and constitutional, be prevented, arrested, retarded, or cured. 3. The circulation of the blood must be regulated. 4. Faulty digestion rectified. 5. Constant supervision of the eye must be maintained by a competent ophthalmologist, that the eye strain be relieved, and all changes in refraction be properly remedied. 6. Treatment by conjoined manipulation and instillation should be instituted at the earliest possible moment. 7. Finally, if local and constitutional treatment should not provoke a favorable issue, they will establish a more nearly normal state of the ocular tissues, and if an operation be found necessary, this improved condition of the ocular structures will ensure a large degree of success. PAYNE. Report of Thirty-One Cases of Intubation.-In the Natural Medical Review for June, 1899, C. W. Richardson presents a tabulated report of thirty-one cases of laryngeal, and laryngeal and pharyngeal diphtheria requiring intubation. The KlebsLoffler bacilli were present in all cases, and the stenosis was severe in all but two. Seven deaths occurred, a mortality of 22 per cent. One of the cases that recovered had been intubated eighteen months prior for diphtheria, which would tend to show that one attack does not confer immunity as some hold. Antitoxin was used in connection with intubation in these cases and the writer expressed the belief that when such treatment is given, a resort to tracheotomy will not be needed. The dose of antitoxin should be from 2,500 to 3,000 units for children over two years of age, and for those under that age from 1,500 to 2,000 units should be given. He found most difficulty in intubating between eighteen and thirty-six months of age, but could assign no reason for this. In these cases the tube is allowed to remain until the fifth or sixth day. L. C. DEANE. PACIFIC MEDICAL JOURNAL. WINSLOW ANDERSON, A. M., M. D., M. R. O. P. LOND., etc. W. F. SOUTHARD, A. M., M. D., Managing Editor. A. P. WOODWARD, M.D. JOHN H. HEALY, M.D. GEO C. MACDONALD, M.D., F.R.O.S.Ed. EDW. E. HILL, M.D. J. BURRIS WOOD, B.S, M.D. E. S. PILLSBURY, M.D. WM. J. JACKSON, Ph. G., M.D. F. F. KNORP. M.D. SOPHIE B. KOBICKE, M.D. WILLIAM EDWARDS, Ph.G., M.D. J. J. KEEFE, Ph.G., M.D. C. L. WEITMAN, Ph.G., M.D. THOS. MORFFEW, D.D.S. CORYDON B. ROOT, M.D., D.D S. A. C. HART, D.D.S, M.D. WILLIAM A. BRYANT, M.D., D.D.S. J. HENRY FLINT, Ph. G. J. F. DILLON, A.M., M.D. The Editors are not responsible for the views of contributors. All matters relating to the editorial and business departments should be addressed to the PACIFIC MEDICAL JOURNAL, 901 Sutter St., San Francisco. SAN FRANCISCO, JANUARY, 1900. Editorial. SAN FRANCISCO'S NEW BOARD OF HEALTH. Mayor Phelan is to be complimented upon the selection of members for the new Board of Health. The gentlemen are all physicians of prominence and experience, and will undoubtedly earnestly endeavor to protect the health of the city, and take good care of the various city and county institutions. The new Board is composed of Dr. Louis Bazet, 'Dr. R. W. Baum, Dr. W. E. Hopkins, Dr. J. M. Williamson, and Dr. William D. McCarthy. The members of the 'retiring Board deserve the thanks of the community for 'the efficient services they have rendered during the past. THE NEW UNITED STATES DISPENSATORY. The eighteenth, and latest, edition of the United States Dispensatory, just issued, is undoubtedly the best book of its kind extant. The editors, Messrs. Wood, Remington, and Sadtler, have certainly excelled themselves, and have given to the world a reference volume on materia medica, pharmacy and therapeutics which leaves little to be desired. The compilation is perfect, and the innumerable subjects treated are handled in a concise and forceful manner. Part I of the work is devoted to a consideration of the subjects treated of in the pharmacopoeias of the United States, England and Germany, as well as the preparations of the French codex, which have found common uses in the United States. The Dispensatory is fittingly called a commentary on these works. The practical utility of the work cannot be overestimated. The vegetable drugs are treated botanically, chemically, physiologically and medicinally. The medical properties, dose and official preparations are also given. In short, nothing is left unsaid. Part II has many new and important features, among which might be mentioned the addition of two hundred new drugs. Part II, Section 1, gives a reprint of the unofficial preparations of the national formulary, as raised by the American Pharmaceutical Association (1896), which is certainly a valuable addition. In Part II, Section 2, on new and nonofficial medicines, physicians and pharmacists will find a longfelt want supplied. Part III treats of the official tests, reagents and test solutions, besides various useful tables. An excellent chapter on the art of prescribing is found in the back of the book, metric prescriptions, weights and measures receiving careful attention. As it stands to-day, the eighteenth edition of the United States Dispensatory is a book that no progressive pharmacist or physician can afford to be without. W. J. J. DR. LEONARD WOOD'S PROMOTION. Dr. Wood, a genial, wholesouled, splendid fellow, is very well and favorably known in San Francisco as a member of the Bohemian and other clubs. When the war broke out with Spain he went with Col. Roosevelt's Rough Riders as their |