Treatment of Ranula.-Stimson directs to catch up the anterior wall of the cyst with toothed forceps, and excise, passing a director at intervals between the sides of the incision to prevent reunion. The filling up of the sac may be hastened by painting its interior with nitric acid or tincture of iodine.

Influenza of Children.-H. B. Sheffield (New York Medical Journal, June 30) has found that sodium benzoate will relieve all symptoms within forty-eight hours. For severe pain he uses also codeine; for rheumatoid pains, salol; for high fever, acetanilid. He also employs compound tincture of benzoin by inhalation.

Notice. All Surgeons, Assistant Surgeons, Acting Assistant Surgeons or Contract Surgeons, and Hospital Stewards, who served in the Army or Navy of the late Confederate States, will please send their post-office address to Deering J. Roberts, M.D., Secretary Surgeons' Association, C. S. A., Nashville, Tenn.

Local Treatment of Uterine Hemorrhage.-H. Ostermann (quoted in Philadelphia Medical Journal) has used successfully in thirty cases a mixture of equal parts of antipyrin and salol, melted over the spirit flame and applied on an aluminum rod to the cerviconterine canal, after thorough cleansing of the vagina and cervix.

Moulds in the Stomach.-Einhorn reports four cases (Medical Record, June 16) in which spores and mycelia were present in the stomach washings. Three of these were hyperchlorhydric with periodic gastrosucorrhea; the fourth was a chronic glandular gastritis with erosions. The treatment recommended is lavage, the gastric douche and a spray of silver nitrate.

Insurance and Christian Science.-A wise step has been taken by the Supreme Lodge of the Knights of Honor in voting to exclude from the order faith-curists and christian scientists. Other insurance organizations, particularly fraternal associations, would do well to follow this example, since there is no good reason why sane members should have their premiums increased by being kept in the same class with cranks and fools.

Heroin A Correction. — Through a typographic error we were made in a recent number, in speaking of coughs, to state the dose of heroin as being 1⁄2 to 1-6 grain. We take pleasure now in correctly stating that 1⁄2 grain of heroin represents the maximum daily quantity and should never be given in a single dose. The ordinary range of dosage of heroin varies from 1-24 to 1-12 grain for adults (exceptionally 1-6 grain); 1-120 to 1-30 grain for children. Heroin hydrochloride, being freely soluble, is best adapted for general medical practice, and is well given after food, along with a small amount of hydrochloric acid.

The Diazo Reaction in Tuberculosis. From a considerable laboratory study of the subject M. Michaelis (Berl. Klin. Wock.) concludes that a persistent diazo reaction in an afebrile patient is generally indicative of tuberculosis. The reaction usually occurs in advanced phthisis and is an unfavorable prognostic sign, the majority of such cases ending fatally within six months.

Special Forms of Edema.--Dr. Schuler (quoted in Medical Review of Reviews) calls attention to the usual forms of dropsy and to others which are commonly overlooked as to cause. One of these conditions is concretio pericardii, which occurs in the relatively young and is at the bottom of many cases of weakened heart. Edema of the legs in fat people is due to lymph stasis. It is often mistakenly considered of cardiac origin, but cannot be remedied by cardiac tonics.

Medical Talk."-This is the name of a printed pamphlet issued quarterly in the interest of the "Hartman Sanitarium," of which one D. R. Summy, M.D., is superintendent, editor and the "whole thing." Some first-class paper is wasted in attacks on vaccination, laudation of patent medicines, etc. The doctor is evidently an anti and his effusions are designed to capture old aunties. He would do better to re-christen his "journal" AntiMedical Slush.

Prizes for Essays on Tuberculosis. In order to stimulate practical knowledge in this direction, the Medical Mirror, of St. Louis, offers $1,000 in seven prizes ($50 to $500) for thesis on tuberculosis. Entries close Oct. 1, 1900, and award is made Jan. 1, 1901. The committee on awards includes Wm. Osler, Geo. F. Butler, A. R. Kiefer, C. Lester Hall, H. R. Hall, L. E. Lemen, Jos. M. Mathews, W. W. Grant, Thos. H. Stucky, Hugo Summa and Walter Wyman.

Liquid Air for Boils and Carbuncles.-Dr. A. Campbell White, of the Vanderbilt Clinic (Medical News) has found this remedy capable of aborting boils, by complete freezing, followed by multiple pricks. He claims it is the best form of treatment for carbuncle. Spray is introduced into the openings and then applied externally. A dry absorbent dressing is applied, as there is very free bleeding from reactive hyperemia. Liquid air has almost entirely replaced the cautery at this clinic.

AGENTS WANTED.—To sell the Marsh Reading Stand and Revolving Book Case. Best office or library article ever patented, and sells everywhere on sight, at a good profit. Why stand idle with such a chance to make money? Ask the publisher of this jour nal to show you sample of this stand, or write us for full particulars at once. MARSH MFG. CO., No. 542 West Lake St., CHICAGO.

DENVER MEDICAL TIMES

VOLUME XX.

SEPTEMBER, 1900.

NUMBER 3.

ORIGINAL COMMUNICATIONS.

REFLEX NEUROSIS FROM DISTURBED PELVIC
MECHANISM.

By BYRON ROBINSON, B.S., M.D.,
Chicago, Illinois.

The amount of nerves that supply the genitals is enormous. The internal genitals are overwhelmingly rich in strands from the sympathetic. The uterus, oviducts and ovaries are innervated chiefly through the hypogastric and ovarian plexus. The vast hypogastric plexus, consisting of some thirty strands, is intimately connected with the spinal cord through the nervi communicantes, and to the sacral plexus by many large strands, especially from the third sacral (by some trunks), and the fourth sacral (by three to four large trunks). These nerves lie on each side. of the uterus, at the junction of the corpus and cervix uteri, forming a ganglion over an inch long, a half inch wide, and of various thickness. I will term this ganglion the pelvic brain. These ganglia (cervico-uterine) are the bulb-like termination. of the hypogastric plexus. The utero cervical ganglion receives eight to ten large nerve trunks from the third and fourth sacral nerves (occasionally some from the second.)

The Pelvic Brain (cervico-uterine ganglion), seems to receive all spinal nerves before they pass into the uterus. The nerves in passing through the cervico-uterine ganglion become demedullated. More nerve strands pass out of the pelvic brain than enter it. The ganglion sends off scores of nerves to the uterus and oviducts; also to the bladder and rectum. It requires months to dissect out the nerve connection of the genitals. The kidneys and genitals are very intimately associated by nerve strands.

Embryologically this is plain, as the genitals and the kidneys arise from the same Wolfflan body, which practically had the same blood, nerve and lymph supply. The internal genitals and the rectum are very intimately connected with the diaphragm by the hypogastric plexus and lateral chain which passes directly to the inferior cervical ganglion. From the inferior cervical ganglion a large strand of nerve originates and passes directly to join the phrenic, which comes from the third, fourth and fifth cervical and passes to the diaphragm. There is a direct nerve connection from the genitals and rectum to the diaphragm. This will explain "uterine cough," capillary flushing, the braying sound and the rapid onset of breathing during rectal dilatation. Anatomic dissections disclose that the genitals are situated at the periphery of the richest nerve plexus of the whole body. That they have vast nerve routes to the spinal cord through the same plexus and nervi communicantes, that they have profound connection with the abdominal brain and kidneys, a direct nerve route with the diaphragm and extensive connection with the tractus intestinalis and accessory organs. The sympathetic nerve is a visceral nerve though connected with the cerebrospinal axis by the rami communicantes, yet it exercises considerable independence. The cerebro-spinal and sympathetic systems may be compared to federal and state government, each exercising certain independent functions, yet for permanent existence one is dependent on the other. However, the sympathetic plays the chief role in rhythm and in ruling viscera. The sympathetic nerve is a nerve inseparably connected with the blood and lymph channels. It dominates the size of vessels. The sympathetic may be divided into (a) the lateral chain which extends from the ganglion of Ribes along each side of the vertebral column to the ganglion Impar. This chain of ganglia appear to correspond to the vertebral segments and are connected to the cerebro-spinal axis by the rami communicantes. The ganglia demedullate nerves (b). Another important division of the sympathetic is the three great pervertebral plexuses, in the thoracic, abdominal and pelvic cavities. They are single, located in front of the spine, each plexus is situated in a different cavity and governs a visceral territory.

The thoracic plexus, which rules the heart and lungs, was early in vertebral life segregated by the diaphragm. The greatest pervertebral plexus is the solar or abdominal brain. This is the great ruler of visceral existence-nutrition and visceral rhythm. It is the primitive collection of visceral nerve ganglia, and all

abdominal plexuses originate from this abdominal brain. Here was located the Wolffian body which originated the genitals and kidneys. The abdominal brain exercises vast influences on circulation as it is connected by blood and lymph channels with almost every region of the body. It dominates visceral rhythm and the secretions of the abdominal and pelvic viscera, effecting deficient, excessive, or disproportionate secretions.

(c) The third great pervertebral plexus is that of the pelvis-the pelvic brain. The pelvic brain is extensive and only secondary to the abdominal brain. It moved caudal-ward with the Wolffian body and generative organs. The extensive strands of the hypogastric plexus (perhaps 30) pass from the abdominal brain, in front of the vertebral column, along the aorta to the pelvic brain (cervico-uterine ganglion). The large pelvic brain is composed of the termination of the hypogastric plexus, with branches from the second, third and fourth sacral nerves. The pelvic brain receives and demedullates the nerves before the emergent multiplied strands pass to the genitals, bladder and rectum. A peculiar feature in regard to the abdominal viscera is that not only the lateral chain of the sympathetic is connected to the spinal cord by the rami communicantes, but the abdominal brain, the anterior extremity of the visceral nerves, is connected to the cerebro-spinal (vagus) nerves and the pelvic brain, the posterior visceral nerves, is connected to the spinal nerves (second, third and fourth sacral).

The remarkable feature disclosed by dissection is the excess. of nerve supply to the genitals over other abdominal viscera. The spermatic plexus is a branch of the hypogastric, which, however, has but little connection with the pelvic brain. The routes which nerve forces pass from the genitals are (a) by the way of the hypogastric plexus, (b) by the way of the lateral chain, (c) by way of the ovarian plexus, and (d) by the way of the spinal cord. A final division of the sympathetic nerve is what I shall term the automatic visceral ganglia, located at its distal periphery, in each abdominal organ. Those located in the oviducts and uterus I have termed the automatic menstrual ganglia. We thus deal with the cerebro-spinal nerves, richly associated with the abdominal viscera at he anterior and posterior extremity; with the lateral chain of the sympathetic, connected to the spinal cord by the rami communicantes; with the three great pervertebral plexuses, and finally with the automatic visceral ganglia. Anatomy thus discloses the fact of exceedingly rich nerve supply to the