squeezed from a sponge. The evaporation is regulated according to the need for refrigeration, the sheet being covered with a flannel blanket when 101 is reached and removed at 100°. The wet applications are kept on from half an hour to almost constantly for a week or two. There is a great difference in people in the effect produced. I have recently seen a case of very precipitate character. A girl nine years old complained of feeling badly, but attended school as late as Tuesday of last week. Thursday a physician was called but became alarmed and sent for me Friday afternoon. I was unable to go that day and waited till I was sent for again the next afternoon. The child's temperature was only 1031⁄2, but her face was ashen and she was between delirium and coma, and died twenty-four hours later-five days from the time she was in school. Some ten years ago I had a similar case in the same neighborhood. In neither case was there tympanitis or other sign of intestinal perforation, and the course was so short that it did not seem possible that it could have occurred. The only conclusion I could form was that the vitality had been overwhelmed by a rapidly developed toxæmia.

Concerning diphtheria that was under discussion when I came in, I have had only two cases lately. They both recovered, but one of three cases in another family in the same house was fatal. That one may have been sick

er than the others and might have died anyhow, but he was reported to have become immediately and rapidly worse after the injection of antitoxine. I knew of the case only by hearsay, but some of the neighbors think the injection killed the child.

Dr. Kershaw.-I think a great many cases of so-called malarial fevers are really mild forms of typhoid fever. Quinine is a useless remedy in such cases, and not only useless, but decidedly harmful. I always begin the treatment of such cases by flushing the colon with hot water in which there is some antiseptic, such as carbolic acid, listerine or peroxide of hydrogen. I believe that these fevers are due in many cases to the presence of septic material in the intestines. The temperature usually begins to fall after the first injection. The injections alone will sometimes cure these cases without any medicine. Frequent bathing of the body with cold water tends to lower the temperature and should always be a part of the treatment. Homœopathic remedies such as gelsemium, arsenicum, nox vomica, baptisia, bryonia and rhus toxicodendron are usually sufficient to cure cases of this kind. cases, without exception, should receive liquid food only. Solid food will prolong such cases and often lead to a fatal ending. These fevers are usually gastric fevers, it matters not what name be given them, and treatment given with this idea in view will generally bring about a favorable termination.

All

THE Northrop method of admin

istering chloroform is rapidly gaining in favor with surgeons of the highest standing and experience, and the recent enthusiastic verdict of Dr. McClelland of Pittsburgh, that Dr. Northrop's discovery is "second only to that of anesthesia itself," and is "the greatest advance in this department of surgery that had yet been made," bids fair to find echo throughout the land. Dr. McClelland's chronicle of recent experience, published in the August issue of the North American Journal of Homœopathy is of such significance and interest that we take much pleasure in reprinting extended quotations from it:

"I concluded to try the method in our Pittsburgh Hospital. The first case was that of a woman with a weak heart and easily embarrassed respiration. We found that she went under the anesthetic promptly and without struggle. The pulse, which before the operation was running 120 per minutes, shortly afterwards subsided to 72,and at that continued until the conclusion of the operation, if anything growing stronger toward the close. This patient was under the operation for one hour and forty-five minutes. To my amazement it was found that she had consumed during that period of perfect anæs

thesia but 6 drams of chloroform. To be sure the cylinder of oxygen, holding 40 gallons, was about empty. The patient at the conclusion of the operation had a much better pulse than at the beginning, and came out of the anesthetic without nausea. "This experience was highly gratifying. I felt that Dr. Northrop had made a discovery second only to that of anæsthesia itself. By common consent the whole staff of the Hospital agreed to use the oxygen method, and now for a period of four months there has been nothing else used in the Institution. I may say that the subsequent experience of all has been a repetition of this first case, namely, prompt anæsthesia, improvement in the heart's action and respiration, with little or no

nausea.

One extreme case required anesthesia three hours and forty minutes and during this long period consumed just 15 drams of chloroform.

"The method of administering the anæsthetic is quite simple. In fact it is merely substituting oxygen gas for air as in the ordinary method. I use a Krohne and Sesemann, or Junker inhaler, and instead of forcing air through a bottle of chloroform in order to atomize it for inhalation, a rubber tube is connected with the cylinder of oxygen, and the lat

necessary.

"These cylinders of oxygen are to be had at the dental depots with the tubes and other attachments, with the exception of the inhaler, which must be purchased at an instrument shop.

DRS. GAUTIER and Larat have

recently reported some marvelous results, which have been obtained in cases of uncontrollable nausea and vomiting of pregnancy, from the use of the continuous current, according to the method of Semnola. These cases, which had resisted all other treatment, yielded quickly and entirely to a descending galvanic current applied to the pneumogastric nerve. The technique employed was as follows:

The positive pole, a rod of carbon or metal, covered at tip with moist. chamois-skin or cotton, was applied just above the clavicle on a point between the points of origin of the sterno-cleido-mastoid, while the negative, a pad 6 or 8 inches in diameter was placed over the stomach. Weak currents, not exceeding 8 to 10 milliamperes in strength only, were used, and each treatment was continued from 15 to 30 minutes. At the end of the treatments, the current should be turned off very slowly to avoid any sudden shock. In bad cases, the treatments should be given several times daily.

The following is a translation of the detailed account of one of the cases reported:

CASE 1.-Uncontrollable Vomiting of Pregnancy of Thirty-Six Days' Duration with Insomnia and Extreme Prostration Cured in Ten Days.-Mrs. K., primipara, health has always been good, and menstruation regular. Last appearance of menses, 8th of Janu ary, 1895. Nausea and vomiting began on the 22nd of February. The patient could take no food, solid or liquid, and had from 40 to 50 attacks of vomiting in the twenty-four hours, which were accompanied with very intense epigastric pains and frequent faintings. During the second week her nights became very bad and her pulse very weak, and from this time on she failed daily in strength and weight. From the first there was obstinate constipation.

The condition of the patient became so bad that only a little water was retained, and there was a complete insomnia, great physical depression, and cerebral excitement. Remedies of various kinds, including opium, chloroform water, co

caine, bromide of potash, chloral, lavage which seemed only to aggravate the trouble, milk regimen, inhalation of oxygen, ice, injections of morphine, were tried without effect.

Prof. Dieulafoy, who was called in consultation, considered the case a very grave one, and advised an increase of the doses of morphine, and if relief was not soon obtained, that the pregnancy be terminated.

The case had now become desperate, and the patient was slowly dying of inanition, On the 25th of March, Dr. Champetier de Ribes was called in consultation, and advised immediate resort to galvanism. In view of the grave condition of the patient, treatment was at once begun, the arst application being made at 9 o'clock the same evening. The patient, who had retained nothing for 35 days, took and retained, after the first treatment, half a glass of milk, and an hour later another half glass was retained. There was also a diminuation of the pain, nausea, and spasms of the esophagus; and up to 3 A. M. there was neither nausea nor vomiting. The rest of the night was bad, and an injection of morphine was given.

The second treatment, at 9:30 in the morning, was followed by equally good results, but during the day an attack of violent nervous excitement occurred, which was followed by a return of the pains and the nausea and vomiting.

A third treatment was given after midly, and a fourth during the evening, and from this on an amelioration setin, which was continuous. The attacks of nausea and vomiting became less and less frequent, the

pulse improved, the constipation yielded, and upon the third day the patient slept without morphine. For the next three days, three treatments a day were given, and during the next five, two.

The patient could now take solid, as well as liquid food-eggs, chicken, ham, milk, coffee and soups, being well borne.

By the eighth day a cure seemed established, but one daily treatment was kept up, the patient constantly improving until the sixteenth day, when she was able to get up and walk, and leave Paris for the country.

Nine similar cases, with similar results, are reported.

The authors consider the treatment well worth a trial in other forms of nervous vomiting.

The following conclusions are reached:

1st. That the continuous descending current, applied to the pneumogastric according to the rule given, constitutes an efficient remedy for vomiting.

2nd. That it appears to be a curative agent of the first order in the vomiting of pregnancy.

3rd. That in vomiting due to grave, or even mortal lesions of the central nervous system, electrization brings about a cessation or a considerable lessening of the symptoms.

4th. That the treatment is rapid in effect, and no adjuvant medication is required.

In the discussion of this paper, Dr. Bardet stated that he had tried the treatment in 22 cases of uncontrollable vomiting, but had only found it successful in 10. He had only found it useful in cases of purely nervous

vomiting. In the vomiting of preg nancy, it had failed entirely. He had generally used the method of Semnola, descending galvanism of the pneumogastric, but, in three cases, he had tried the introduction of one electrode into the stomach. These cases were among those in which the treatment failed to give relief. The duration of his treatments never exceeded five minutes.

In closing, Dr. Larat said that the length of time of the application was of the greatest importance. The treatments should be continued for 15, 30, or even 45 minutes, and should be repeated several times during the day.

The series of successful cases rebut he had it from Semnola himself ported was doubtless a happy one,

that he had never had a failure.Virginia Medical Monthly.

DR. AUGUSTIN H. GOELET,

New York, read a paper on this subject at the recent meeting of the American Medical Association at Baltimore in which he stated that the contention was not that these inflammations of the tubes and ovaries can always be cured but that it is frequently possible, and unless immediate operative interference is absolutely demanded, the patient should be given the chance and the attempt should be made before submitting her to a radical operation. This he thought particularly important since treatment directed toward attaining this end did not militate against a subsequent operation for their removal should it become necessary, but, on the contrary, improved the chances of an ultimate successful result. He called attention to the fact that when once removed these organs cannot be replaced, and asked the question if it was not a serious error, in the light of recent developments in the etiology and pathology of the inflammations of the appendages, to

remove these organs without previous attempt at a cure or removal of the cause which may be operating to maintain such a condition. It may be denied that the diseased tubes and ovaries are removed unnecessarily, but it must be admitted that they are too often removed for disease which is amenable to patient and persistent treatment, or which may be cured by a minor surgical operation, involving no risk, such as curettage or repair of a lacerated cervix.

If these cases are submitted to careful treatment instituted for the purpose of clearing up the surrounding exudation and favoring drainage through the natural channel, (the uterus) in many instances the necessity for a radical operation would be removed, and the woman would be restored to a life of usefulness and happiness.

In corroboration of these views, he reported twelve selected cases which had come to him from other gynecologists, who believed that removal of the diseased organs was the only