locally; dressings were reapplied in form of compresses of lint and bandage, which were ordered to be kept saturated with the same solution, over the wounds. This same remedy was given internally, in the form of 3 d. trituration, in three grs., doses to be repeated every three hours, except when asleep at night. He was allowed to maintain the position in which he was found, and diet was ordered to be continued as before. Called again on evening of same day and found the patient somewhat easier, his pains had been much relieved, pulse had dropped to 100, skin disposed to be moist and cooler, but thirst the same as in the morning. Tenderness over the abdomen, and tympanitic condition slightly less; drew off the patient's urine by means of the catheter, which was left in and secured, also stopped by means of a plug in order to enable the patient to be relieved through the night by simply removing the

cork.

Sixth Day.-7 A.M., patient looking brighter, general condition somewhat improved, pulse 98, thirst decreasing, had passed urine three times during the night, which was stronger in its odor, less in quantity, depositing a heavy brick dust-like sediment. On removing the dressing found the wounds looking better, tumefaction less, erysipelatous condition considerably abated, tongue looking more favorable, coating changed to a white fur. Redressed the wound, and ordered the continuation of internal and external treatment and diet. On the same evening, called and found him improving, ordered continuation of treatment and diet throughout.

Seventh Day-Patient passed a comfortable night, resting better than usual. No change to report worthy of note, except that of general improvement in the condition of the wounds, absence of tympanitis, but the urine remained turbid and strong, for which berberis, vulg. 1st, in tablespoonful doses, prepared in the proportion of ten drops to a half tumbler of water, and repeated every three hours. The wounds were cleansed and redressed, containing the sulphide of soda solution locally not so frequently applied.

Eighth Day.-Patient still improving, wounds progressing well, removed some of the sutures, commencing at the terminal ends of the wound, to the number of half-a-dozen, also some three or four that had cut their way through on one side, caused by the previous tumefaction and pre-existing erysipelatous condition, at the junction near the symphesis pubis. Returned now to the carbolized oil dressing, applied on picked oakum, covered in with compresses and bandaged as before. Urine less turbid and flows in larger quantities, without the use of the catheter, which was in use up to this time, having been removed and cleansed morning and evening since its first introduction into the bladder. Patient's appetite seems vigorous, wants to eat more substantial food, which was allowed, viz.: rare beef steak, soft-boiled eggs, coffee, mashed potatoes, milk toast, etc., continuing the punch and beef tea if desired. Patient has desire for stool, administered warm enema, gently passed up through the rectum until it could be felt in the colon, by means of the hand through the abdominal walls.

This he retained some twenty minutes, then was followed with stool that did not appear of recent formation, but looking rather like the old impacted stool he passed before the operation. Pulse 90, tongue almost cleansed of its fur and moist, patient's general condition good and promising. There is nothing further of note to report, than the fact that the wounds healed kindly by granulations, at the points that had been invaded with erysipelas, viz., at the junction of the two incisions. The patient passed on to a speedy recovery, considering all the remarkable circumstances of his case, as well as to the surprise of those who had predicted a fatal issue in the event of an operation. Some after-treatment was necessary in regard to regulating the bowels.

The patient being of a nervo-bilious temperament, predisposed to costiveness, having been somewhat dyspeptic and troubled with sour stomach, during the previous years of his last illness, nux, vom, 6th trit, was given three to four times daily, which after one week's use restored both stomach and bowels to their normal functions. Eight years later the patient was still living, enjoying a comfortable degree of health; this information the writer was informed of by one of the patient's neighbors, whom he casually met while living in Cleveland during the year 1869; the operation was made early in May, 1861.

RUPTURE OF AORTA.

BY CHAS. MCDOWELL, M.D., RESIDENT PHYSICIAN, HAHNEMANN HOSPITAL, LATE HOUSE SURGEON, HOM. HOSPITAL, W. I.

F. C; male; aged 47; Ireland; laborer. Admitted to Homœopathic Hospital, Ward's Island, August 30th, 1878.

The following is a summary of his history. Several years ago, patient had an attack of acute articular rheumatism, followed by cardiac trouble, from which he still suffers. Has been subject to occasional attacks of severe pain near the region of the heart, accompanied by palpitation and dyspnoea; has had more or less dry cough, and several attacks of profuse hæmoptysis, with marked dropsy at times; though he has been greatly prostrated, patient has not lost appreciably in weight.

Two weeks ago a sudden hemiplegia appeared, which began to improve immediately, and has now almost entirely disappeared.

At present suffers principally from vomiting, having been unable, for several months, to retain more than a very small amount of food at a time; suffers no pain, sleeps well, except when suffering from occasional attacks of palpitation.

Physical Examination.-Body well developed, muscular condition good.

Lungs. Respiration somewhat increased in frequency. Pulmonary resonance normal. Vesicular murmur slightly harsh.

Heart.-Apex beat well marked, two inches below, and three-fourths of an inch to the left of the nipple. Area of præcordial dullness largely increased. Heart sounds intensified; no valvular murmurs detected.— R Ipecac. o

August 31st.-At 11.20 P. M. patient had an attack of syncope; was found lying on the floor, at the side of his bed, in an unconscious state, pulseless, and with no appreciable heart impulse. In a few moments the pulse became feebly perceptible, rapid, and intermittant. The breathing was labored, the surface of the body cold and covered with a profuse perspiration; face and finger nails purple, eyes protruding and insensible Veratrum alo. ō. aà gtt. x. to light.-Ṛ Digitalis ō.

On regaining consciousness, he complained of an acute pain, intensified by the slightest motion, which extended from the heart to the shoulder and down the left arm. The pulse gradually became more full and regular, the breathing more natural, and the face regained its normal color; yet for some time the patient was confused, replying but slowly to questions.

September 1st, 6 A. M.-The dyspnoea, which had continued during the night, suddenly increased in severity, but was relieved in a half-hour. A few minutes before seven o'clock, he walked into the next division of the ward, where another bed had been prepared for him; here he lay quietly till 7.40 A. M., when he turned upon his side and gasped for breath; a profuse cold sweat appeared on the body, the heart beat tumultuously a few moments, and then ceased its action.

September 2d, 8 A. M.-Autopsy. -Height, 5 feet, 94

Pericardium.-Lymph thrown out over entire sur

Heart.-Weight 2 pounds. 4 ounces. Hypertrophy of whole organ, most marked in left ventricle. Valves normal. No clots in any of the cavities.

Aorta.-Extensive atheroma. One inch above the aortic valves was a rupture, 14 inches in length, of the inner coat, on its anterior surface, parallel with the axis of the vessel. From this opening the blood passed between the coats of the aorta, forming a dissecting aneurism, which entirely surrounded the vessel, extending two inches above the superior extremity of the rent, and about one inch below the inferior extremity; this cavity contained blood clots weighing 74 ounces. On the posterior surface of the aorta, at a point a little below the anterior opening, was found a second one, passing through the external coat into the mediastinum, which contained a large quantity of clots and fluid blood.

Pleurae.-No adhesions, or abnormal amount of

fluid.

Lungs.-Left, weight 1 pound, 6 ounces; right, weight, 2 pounds, 1 ounce. Slight oedema of lower lobes, otherwise normal.

Abdominal Viscera, with the exception of kidneys, deeply congested; especially liver and spleen.

The pathology of this case is of interest, because of its obscurity during life and its clearness upon autopsy; the symptoms, but not the physical signs, pointing to valvular disease with enlargement. The post mortem revealed a lesion extraneous to the heart, giving rise to a sequence of mechanical events, which clearly explain the symptoms exhibited by the patient during In tracing them, we will start with the atheroma. Here we may revert to the occupation of the patient, one in which muscular strain is frequent, this giving an increased impulse to the blood current, causes an irritation of the inner coat of the aorta, which is a principal factor in the causation of atheroma; this accounts for its frequency among athletes.

life.

The resulting atheroma, by destroying the natural elasticity of the arterial walls, acts as an obstruction to the flow of the blood, giving rise to a compensatory hypertrophy of the left heart; the resultant back set of the blood, extending to the pulmonary circulation, causes passive congestion, and its symptoms, cough, and hæmoptysis; this pulmonary congestion gives more work to the right ventricle; it hypertrophies; lastly, the systemic veins become distended with blood; hence the anascarca, and the congestion of the abdominal

viscera.

The hemiplegia is readily accounted for. An athe romatous patch softened, forming a so-called atheromatous abscess; this bursting, resulted in an atheromatous ulcer, whose rough, overhanging edges presented points for the deposition of fibrine. In this way a small thrombus was formed, which being washed away and carried to the brain, caused an embolic hemiplegia. The base of the ulcer, softening still further, then gave way, and the blood diffused itself between the middle and external coats; the resistance of the outer coat was finally overcome, eight hours afterward, producing immediate death, the blood passing into the mediastinum, instead of into the cavity of the pericardium, on account of the adhesions of that membrane.

ASYLUM FOR INSANE.

Mrs. P. was admitted to the Asylum April 3d, 1879. She had been gradually failing in health and spirits for nearly a year. When received, she had the appearance of an old woman, although but about 35. Her features were pale, thin, drawn, sallow and haggard. The patient was very restless, anæmic, and feeble, having had a poor appetite and slept but little for several weeks. She complained of headache, mostly in the occiput; was incoherent in speech, constantly repeating short expressions, such as: "tell me the story;" "give me the papers; 'they know," and other disconnected remarks. Her breathing was labored; inspiration lengthened, expiration very brief. She was much given to frequent and profuse ebullitions of tears. Was quite thirsty and chilly at intervals. Paindifferent results. Natrum muriaticum was at once tient had taken chloral hydrate for sleeplessness, with prescribed and steadily continued. The first night, under this and no other remedy, she slept one and a half hours; the second night she slept four hours, and to do so until discharged. within five days she slept sufficiently, and continued

The improvement in this case was steady and continuous. The symptoms and conditions successfully combatted with natrum mur. were: a general and persistent anæmia; a previously long-continued headache; an appearance of premature old age; and profuse, uncontrollable weeping. It may also be proper to remark that the patient had a history of intermittent fever, quenched with quinine.

In less than two months the patient had rallied from profound physical prostration, and equally profound mental depression; and in less than three months from date of admission she was discharged, a fat, rosy, healthy and happy young woman. Who can say that the fountain of eternal youth is not a salt spring?

INTERMITTENT FEVER-PULSATILLA.-Patient aged 12, living upon the border of a pond fed by a small stream of water which was nearly dry in summer, has suffered from malaria each year. Chill commences in the hands at 11 A. M, and is accompanied by thirstlessness; excessive bone pains; fever lasts one hour, with slight thirst and sharp, shooting pains in forehead; sweat slight; R, Pulsatilla 3d, which promptly cured. Symptoms which led to the selection were, chill commencing in the hands (or feet) and absence of thirst. Certainly the disposition had nothing to do with the choice, for instead of being “mild and tearful," she is chronically as cross and ugly as sin.

L. B. COUCH, M.D., NYACK.

36

OBSTINATE VOMITING IN PREGNANCY.-Another wonderful discovery in therapeutics reaches us through the Medical Record. The of a grain of iodide of potash, repeated every half hour, is found to control severe forms of vomiting in pregnancy. A closer study of friends a host of facts quite as interesting as the above. our materia medica would bring to the notice of our

POST-PARTUM HÆMORRHAGE.-Dr. Penrose used vinegar in the following manner: Saturate a rag with vinegar, carry it into the cavity of the uterus, and squeeze it. In the vast majority of cases the hæmorrhage ceased as if by magic when the vinegar passed over the surface of the uterus and the vagina. He believed that the salts of iron should seldom or never be used; but in a case, which was supposable, in which the vinegar failed, he would resort to that remedy.

CLINICAL NOTES.

The veteran Dr. D. S. Kimball, of Sackett's Harbor, N. Y., is preparing tinctures from many indigenous remedies which he will be glad to furnish at moderate prices. We need not add that they can be relied upon as officinal. He has found hot water locally and Apis internally of service-mainly in skin symptoms-in Rhus poisoning.

He writes that "the tinctures are fresh, and prepared with the greatest care that we get the article represented, instead of some other; for American icy is liable to be mistaken for Phus, the Golden Candlestick for Lill. tig. Dulcamara, etc., etc. I am not satisfied that the Tor and Radicans are one and the same, as claimed by Allen, etc. The Radicans I have never found in this section, but the Tor quite common, while in Onondaga and Cayuga Counties the reverse is the case. The Golden Candlestick very closely resembles the Lillium, so much so that I came near mistaking it several times. The former has a narrower leaf, and flowers earlier than the latter-flowers almost exactly alike. Plantago has not received merited attention. Have cured several cases ear and tooth ache with it, locally as well as internally. A lady whose hearing was imperfect, to whose tooth I applied the tincture, and dropped some reduced with water in the ear, remarked that it not only cured the toothache but improved the hearing. Three years ago I awoke with the toothache; got up and applied the mother tincture, and a few drops, reduced with water one half, into the ear on the affected side, and have never had the toothache since. Three days ago Mrs. Read, who is liable to an affection of the heart, and is nursing a young child, drank some icewater, and was taken with severe clawing pains in the region of the heart, and empty eructations, as of wind from the stomach. Gave Nur, intending to follow it with Lillium or Cac. tus, but did not, as she improved and got comfortable from the Nur. Next day, fat evening, she was suddenly taken with severe toothache, I think in left side I applied the tincture to the tooth and to the ear, and she remarked 'it acted like a charm.' Have seen good results from a decoction of Castanea vesca in whooping cough, and in one case it cured apthæ existing at the

same time.

In the botanical description of Lobelia inf., I think Hale has made a mistake in placing the leaves alternate instead of opposite, as he does not agree with Wood's "Class Book," Torrey, nor my observations. "I have been poisoned, in preparing Rhus, twice before: first in 1847, affecting the bowels (early morning diarrhoea) as well as the skin. Bryonia relieved the diarrhoea. This time it affected mainly the skin, especially the head, hands, wrists-the face and scalp being dematous, particularly around the eyes. I found Apis and hot water nearly scalding to benefit. I have heretofore found Bell., Bry, Bicarbonate soda, and Aqua am., locally beneficial. Have not used the Verbena hastata nor Urtica urens much. Think favorably of the latter as in burns and urticaria. But, I apprehend, the best antidote will be found to be that which best corresponds with the particular symptoms present, whether of the skin, bowels, or otherwise, as was the case with Apis and hot water. Perhaps Urti ca would have answered, but did not correspond with the cedema as Apis did, which was brought forward by our C. N. Y. Hom. Soc.

"Nearly a year ago I had been suffering sometimes with sciatica of the right hip and lower limb, which nothing would control until I used Palladium 30 and 200. Since then there has existed some rheumatism of the right shoulder and arm, leaving the impression that the Palladium cured the sciatica by revulsion." THE homeopathists of Chicago have petitioned the Commissioners for recognition by suitable appointments upon the Medical Board of the County Hospitals.

SPHYGMOGRAPH.-We see by the numerous illustrations in our exchanges, and the reports of friends in private and hospital practice, that the use of the sphyg mograph is steadily on the increase. Until the introwere so complicated, and required such delicacy of duction of the Pond sphygmograph, the instruments manipulation, that very few were in use, and these were in the hands of those who had an abundance of accurate we do not wonder it is rapidly coming into time. The Pond sphygmograph is so simple and yet sʊ various forms of disease and peculiar organic lesions general use. As yet, the aid given to the diagnosis of by the tracing of the pulse is in its infancy, but the revelations valued. Any instrument which will aid more carefully they are studied the more are their us in a correct diagnosis of disease will in time be appreciated in proportion to its real value.

A NEW, CHEAP, AND SELF-GENERATING DISINFECTANT.-Under this title, Dr. John Day, of Geelong, Australia, recommends for use in civil and military hospitals, and also for the purpose of destroying the poison germs of small pox, scarlet fever, and other infectious diseases, a disinfectant ingeniously composed of one part of rectified oil of turpentine and seven parts of benzine, with the addition of five drops of oil of verbena to each ounce. Its purifying and disinfecting properties are due to the power which is possessed by each of its ingredients of absorbing atmospheric oxygen aud converting it into peroxide of hydrogena highly active oxidizing agent, and very similar in its nature to ozone.

ICE IN THE RECTUM IN CHLOROFORM NARCOSIS.According to Dr. Baillee, there is no more active remedy in the narcosis caused by chloroform than the introduction of a piece of ice into the rectum. A moderate pressure suffices to overcome the resistance of the sphincter. The ice melts in the rectum, and immediately a deep inspiration is produced, the precurser of natural respiration and of the re-establishment of the cardiac functions. Dr. Baillee recommends the same means in apparent death of the new-born.—Gaz. des Hopiteaux.

TREATMENT OF ALBUMINURIA BY FUCHSINE AND

ROSANILINE.-Feltz and Bouchert have treated a small number of patients suffering from albuminuria with fuchsine and rosaniline, given in pills and mixture, in doses of three grains per diem. Under this treatment the albumen soon disappeared from the urine. They claim that these therapeutic trials prove, at all events, that both these coloring agents are well borne by the organism, and are relatively harmless.-Deutsche Med. Wochen.

INSUFFLATION POWDERS VS. NASAL DOUCHE.-Dr H. G. Miller, of Providence, deprecates the use of the nasal douche, and insists all medications should be in the form of dry powder, and used by insufflation.— Prov., R. I., Medical Society.

to serve.

Do not allow yourself to be misled by low fees, high sounding titles, or flaunting advertisements. Do not attempt to take less than a three years' course, and a longer time is preferable.

Be absolutely certain that your first course is in a school where histology, anatomy, physiology and chemistry are thoroughly taught, and give your entire attention to these subjects until you have completely mastered them.

From observations in attending this course should you conclude that you are not at home in the school of your adoption, and that you have not found your alma mater, do not hesitate to seek her elsewhere, for it is of great importance to you that your studies should be prosecuted in a genial atmosphere, where only the greatest good to you can accrue.

Your second and third courses should be taken in the school which offers the best inducement in the way of clinical teaching—a point you must take means of ascertaining positively, and not depend upon the announcements of the schools themselves, all of which claim superior advantages in this particular. The school which furnishes the best clinical instruction is the one you want to join.

During the term do not attempt too much collateral reading, but rather confine yourself to concise text-books and try to commit to memory the characteristic points of the various branches. Between the terms you will have time for more general reading. Attend faithfully upon all lectures and quizzes, never losing one, if you can help it.

Systematize your work, and if possible allow nothing whatever to interfere with its prosecution. Remember that you cannot expect to read until you have learned the A, B, C's! So in the study of medicine, be sure that you are quite familiar with its fundamental principles, before you attempt to build the structure which will be permanent, for otherwise you will have built in vain, as your foundation is of sand, and will sooner or later show its weakness.

QUACKS AND QUACKERY. WORCESTER defines the noun, which is the subject of this article, with synonyms which are applicable at this time, as "To brag loudly; to talk ostentatiously; a boastful pretender to medical skill; any boastful pretender to a science or an art; the common and popular term applied to an ignorant practitioner of medicine, falsely pretending, or falsely alleged to cure diseases!"

serve the doings of members of our noble profession, we are constrained to the belief that quackery is confined to no particular sect in medicine. In all, we find some who "talk ostentatiously," or "falsely alleged to cure diseases."

We quote from Dr. Richardson's admirable address "On Phases of Quackery," delivered before the Medical Defence Association, and printed in the Medical Times and Gazette, as follows:

So intricate and delicate are the relationships between the profession of medicine and the public, that whatever is for the real benefit of the profession is equally for the benefit of the public. The higher the professional standard of medicine is raised, the higher are the members of the great body of medicine placed above want, and therefore above the temptation to commit sin. The higher the members of the profession are advanced in the social scale, and of worthy public estimation, the better are the true interests of the people in all that concerns the care of their health, considered, served, and satisfied.

The reason why these positions are as I have stated, is plain enough, and is in the nature of things positive. That which the sick man requires, first of all, in his sickness, is protection. He is disabled, and must be protected-protected against himself more than against any one else; for the strongest of men and women, the strong of mind sometimes even more readily than the weak, are very soon off their mental balance when the travails of disease overtake them. It has been in the range of my own experience more than once that the most educated of physicians, and, in their periods of sound health, the most fervent in their de testation and denunciation of quacks and quackery, have, during diseased states of body, not of a fatal character, been ready to run after the veriest scamps in the ranks of quackery, and to resort to the most wanton and foolish of quackish devices, paying the quacks withal for their knavish tricks, while willing and unselfish brethren have been taxed to wait and attend without so much as a thought of compensation for time, anxiety, and trouble.

With such fac's as these staring us in the face what shall we say to the members of the general public, if they, in like manner, under the mental alienations of disease, or under alienations of fear and love for those dearest to them, run from the learned and honest to the illiterate and knavish, and seek, in the depths of superstition, what they think they have failed to find on the heights of science? What shall we do to meet the danger to which these seekers expose themselves, and to lessen the communicating and communicated evils which that seeking tends to keep alive? Quacks are born, not