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times a shrill, barking cough; but up to a few hours, perhaps, before being called in, there had appeared to the parents or friends no particular cause of alarm. But to the practiced ear there are the unmistakable symptoms of danger the peculiar cough; the deep, stridulous breathing so pathognomonic of croup. High fever and extreme dyspnoea, and many or all of the symptoms before mentioned are possibly present. The case is evidently one of ordinary non-membranous croup, but in order to make our diagnosis clear beyond doubt, we make an examination of the throat and fauces, where we find no signs of exudation present. Thus the history of the case, along with close attention to the general physical lesions, and a careful examination of the throat, establish beyond question, no matter how severe the case may be, that we have present the catarrhal form, and that our remedies must be given to reduce the congested, swollen state of the lining membrane of the great air passage, and not for the purpose of removing a false membiane, as we once supposed necessary to cure our patient.

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Now let us, as concisely as possible, point out the train of symptoms which present themselves in the membranous or diphtheritic form of croup. It may be asked: Do the two diseases require a different treatment, so as to make a differential diagnosis of importance? I answer, yes; it is of the greatest importance that we should settle in our mind at as early a moment as possible whether we are to prescribe for the catarrhal form or the diphtheritic, as the treatment, as I shall endeavor to show, widely differs.

we have cases of diphtheritic croup where there is no false membrane visible to the eye. A few years ago I saw a beautiful child of five years die of croup where no exudation, from the most careful examination, could be discovered during life. But the case was beyond question diphtheritic, as established by the premonitory symptoms, and the fact that two of his brothers were ill with diphtheria when the little fellow was seized.

The absence of the false membrane on the tonsils or pharynx, together with the apparently sporadic character of the attack, often make the diagnosis more obscure between the laryngeal and diphtheritic types, but the obscurity is more apparent than real; for, as a general rule, we have the almost unmistakable history of the case to guide us. On the one hand, laryngeal croup is purely a local complaint, with little, if any, constitutional disturbance. The patient, possibly up to the moment of our visit, has been playing around the room. True, we may have the same characteristic expectoration as in pseudo-membranous angina, but there is the spasmodic dyspnoea, with increasing paroxysms of croup, the husky voice, and the tendency of the disease to spread upward. On the other hand, in membranous croup we have the premonitory symptoms- -the shivering; the general malaise and fever before the croup commenced; the usual soreness and, perhaps, swelling of the throat; and, at the time of our visit, the more or less marked constitutional symptoms. Catarrhal laryngitis, or ordinary croup, is dangerous only from its position. Diphtheritic or membranous croup is dangerous both from its position and the tendency of the exudation to spread downward, and the liability of re-absorption taking place, even when we have apparently relieved the croupal symptoms.

Treatment.-Delays are generally dangerous, but in either form of croup they may prove fatal. As we are usually admonished by our professors of midwifery to Go with obstetric haste," in all cases of confinement, I would give the same advice in croup. See your pa tient at the earliest moment possible,

When we have the exudation present, we will find a different set of symptoms from those mentioned in the laryngeal form. For some days, probably, before the medical man is called, the patient has complained of feeling tired; he has shown a disinclination to play. There has been considerable fever present, but little or no cough; and the cough, if present, is not, so far as I have observed, of the same husky, metallic character" as in the catarrhal form. Later on the patient, if old enough to tell how he feels, will complain of stiffness and soreness of the neck and throat; he becomes more In the laryngeal form the first thing to be done is to and more depressed, complains of feeling chilly, and place your patient in the best position for recovery. "hugs the fire." He frequently puts his hand to his Have him undressed and put to bed between blankets forehead, and says his head aches. Now the disease in a flannel night dress. Rest is a very necessary fachas fairly fastened itself upon the throat, the cough tor to the case. Then see to the temperature of the has become "croupy," and all the symptoms present room; have all drafts closed, a brisk fire made in the in the non-membranous type are now developed. After stove or grate, and as rapidly as possible raise the temcarefully noting the history, we explore the mouth, perature to 75 to 80 degrees Fahr. Have the teauvula, tonsils, and pharynx, and find on some of these kettle placed upon the fire with sufficient water to parts the characteristic exudation, formed to a greater allow the steam to pour out copiously from the spout or lesser degree. We are no longer in doubt as to the when boiling. An india rubber flexible tube carefully true nature of the disease. We have before us one of fitted over the nozzle of the spout and brought in carethe most formidable maladies known to mankind; a ful proximity to the sufferer's mouth, greatly increases malady that most of us would willingly resign the re- the usefulness of this steaming process. But on no sponsibility of treating; for we well know that, not-account should any medicinal substance be added to withstanding the wonderful success that usually at- the boiling water; a pure, moist atmosphere is the obtends the action of drugs when homœopathically pre-ject desired. The soft vapor acting upon the swollen scribed, in diphtheritic croup, up to the present time, mucous surface is a very important agent in the rewe are almost helpless to save our patient when the duction of the same. membrane has once fastened itself upon the larynx and trachea. I have treated over three hundred cases of the disease, and in spite of the best known methods of our art, the mortality has been large. We have here a disease clearly per se. It is not only dangerous from its position, which may rapidly produce death by suffocation, but we have to deal with an almost indestructible membrane, composed of numberless bacteria, which, on becoming re-absorbed, produce the alarming symptoms of blood poisoning. It is true, membranous croup rarely progresses so far as to permit of reabsorption, as it generally terminates life before this stage is reached.

Of course we will meet with cases where, from the advanced state of the disease when we are called in, and from the extreme irritability of the little sufferer, we are unable to explore the throat; and I am satisfied

I prefer hot fomentations to the cold pack; I consider them safer, and of late years have invariably employed them. I am aware that many will not agree with me on this point. Steiner, in Ziemssen's Cyclopædia, strongly recommends cold in the "form of frequently changed cold compresses about the neck," and even speaks favorably of the cold baths advised by Bartels; and, while I do not deny the advantages that may at times accrue from this antiphlogistic plan, in my own practice I have had more satisfactory results from the employment of flannels or sponges wrung out in as hot water as the patient can bear. So far as the internal treatment is concerned, unhappily I must admit I am able to throw little, if any, new light upon its therapeutics. In the inflammatory stage, or better, in the stage of invasion, we have no remedy that compares with Aconite. The potency must be a matter of

personal experience. I prefer the low attenuations, confidence. The literature of the treatment of diphand often in urgent cases prescribe the crude drug. In theria is wonderfully voluminous, and as wonderfully Aconite we find our most powerful weapon throughout useless when put to the test; and we feel surprised the treatment of laryngeal croup. Next in order I that scientific men (and all medical men should poshave found the best results from Spongia, Bryonia, and sess a scientific education) have been rash enough to Phosphorus, administered at the first decimal potency rush into print to advocate remedies that are in most every fifteen minutes, or even oftener in extreme cases. cases worse than useless, as precious time is lost in In the use of Tartar emetic I have found little or no trying them. Notwithstanding the want of success service. In the higher triturations it has seemed inert, that has often followed the administration of the Binand in the lower I have noticed it produce a marked iod of mercury in my hands, I am satisfied that, up to diminution in the patient's strength. Before speaking the present time, it is the best general internal remedy of what may be considered as a last resort-tracheoto- we have. my-I would call attention to a drug which has been employed empirically by both schools of practice in England, namely: Chloral hydrate. My experience with the drug in croup has been very slight, but Dr. John Barclay mentions several cases where all chance of recovery seemed removed, that were saved by the administration of Chloral, "Before the Chloral was given," he observes, "the respirations were from 60 to 70 per minute, the pulse varying from 144 to 156, and weak; the dyspnoea was extreme, and the voice and cough now close and dry. Within two hours after the first dose, great relief in the breathing was observed, the child slept half an hour at a time, the respiration and the pulse fell a little, and, what was more curious, a very copious exudation of mucus began in the larynx and trachea. Indeed, so great did this become that it was necessary to raise the child every half hour, when a little water or sherry was given to produce a cough, by which the air passages were cleared of the mucus. * Gradually the pulse fell and the respirations became slower, till at the end of twentyfour hours the former was only 108 and the latter 30. This treatment was persevered in for forty eight hours, after which milk and sherry only were given. The recovery was slow but steady."

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The dose advised is one grain for each year of the child's age, and administered every six hours. In apparently hopeless cases it is certainly worthy a trial, more especially since the present state of our strictly homœopathic therapeutics in croup is far from encour aging. Now, with regard to tracheotomy, the profession seems divided upon its merits. In nine operations under my notice it failed to save life, but was instrumental in giving ease to the little sufferers.

If it is to be performed, it should not be deferred until the patient is poisoned with carbonic acid, and I believe, where it is resorted to early enough, more uniform success is obtained. Steiner says the time to operate is in what he calls the beginning of the third stage, the so-called stage of asphyxia; but it seems to me that there is considerable risk in waiting until this stage is reached, as the rapidly congesting lungs may cut off all chances of success. I prefer to operate before so extreme a condition is present. But the great difficulty in the way of tracheotomy is the opposition of parents. I have many a time seen some bright boy or girl suffocated when I believe a timely opening of the windpipe might have saved his or her life; but the mother, or father, or both, would sooner let their child die than try so harsh a resort.

The management of diphtheritic croup differs from laryngeal, inasmuch as we have to treat a constitutional disease, of which the false membrane is only one phase. Our treatment must be essentially the same as ordinary diphtheria. The croup is produced by the presence of a foreign body in larynx or trachea, and its removal can only be effected by a treatment that will act specifically upon the disease itself-and here, unfortunately, we must confess our helplessness. Some years ago I flattered myself that, with the Biniodide of mercury and Permang. potass.-the one internally, the other applied to the throat locally-I could cure most any case of diphtheria or diphtheritic croup that might come under my care, but a more extensive experience has since convinced me of the folly of my

The next most important remedies we have are Alcohol and diluted Chlorine water. From the experiments of Oertel, these two substances produce the most marked effect upon the micrococci. I have found that port wine, either alone or combined with the Chlorine, is the best form to administer Alcohol; and it is a matter of surprise often the large quantity of this wine that may be consumed by a diphtheritic patient without producing any sign of intoxication. I notice that some of our writers tell of the wonderful results obtained from Lac. can. 100,000; even one dose curing a most "frightful case! Others speak of Bell., 100,000, and Sac. lac., in a single night relieving a most alarming attack. I gave two years ago the so-called Lac. caninum, C. M. and 1. M., whatever these mean, a fair trial in several of my worst cases, but I failed to obtain the slightest satisfactory result; and I obtained, through a friend, the medicine and full directions from Dr. Swan himself. So far as the administration of the Kali permang. is concerned, I have of late years come to doubt its efficacy in the treatment of diphtheria or diphtheritic croup. I have given the hypodermic injection of the Kal. permang., as advised by Dr. Okie, in two hopeless cases without any effect. The chief value of this remedy is that it removes the very disagreeable fetor in malignant cases.

A specific remedy for diphtheria has yet to be discovered, and the physician who shall discover it will be considered one of mankind's greatest benefactors.

ON THE TREATMENT OF MORBUS COXARIUS BY A NEW METHOD.-1st, to secure immobility of the joint; 2d, to procure extension of the limb; 3d, to take off from it the superincumbent weight of the body; 4th, to provide means to enable the patient to take exercise in the open air. To obtain extension of the limb and to remove the weight of the body, he resorts to the following device: On the shoe of the sound limb an iron sole is applied, three inches high, so as to raise the foot from the ground. This elevated shoe and a pair of crutches constitute the apparatus. As the patient stands on his crutches the diseased limb is suspended. The shoe should be high enough to prevent the toes of the affected limb from touching the ground.

Dr. JOSEPH C. HUTCHINSON.

I HAVE reduced gradually to normal frequency (and thus saved the patient) a pulse, in puerperal fever, that ran 150 beats per minute, by half-drop doses Norwood's tincture Veratrum viride, with one grain quinine administered every two, three, and four hours. I recently examined several patients in Brigham Hall Asylum by "cranial percussion," with a view to "cerebral localization." In a respectable percentage I succeeded. In one epileptic lady, whose skull was broken many years ago, I was enabled to point out distinctly the seat of fracture. -DR. R. J. HUTTON, in Medical and Surgical Reporter.

CHLORAL HYDRATE, in a 50 per cent. solution, is claimed to be of service topically in diphtheria, reducing the strength of the solution as granulations are observed.

CLINIQUE.

OVARIOTOMY.*

strated the fact that the uterus was between them. The case was now tolerably clear. There was no pedicle, for a ligature applied at the lowest point of the base of the tumor would encircle the middle of the uterus. The tumor developing in the left ovary had become adherent to the broad ligament, had encroach

A SUCCESSFUL CASE IN WHICH THERE WAS NO PED-ed upon, and finally enveloped the fundus of the

ICLE.

BY JOHN C. MINOR, M. D.

Mrs. R., of Waterbury, Ct., 59 years old, married, primaparous, had carried the tumor for five or six years. The tumor was a polycyst of the left ovary, and had been tapped three times, about forty five pounds of fluid being removed at each tapping. Sev eral years before, she had been troubled with uterine hemorrhage produced by polypi. One of these was removed, and the hemorrhage had gradually ceased. Condition at the time of operation excellent. She was thin, sinewy, courageous; digestion in fair order; skin and kidneys in perfect action.

Operation, Oct. 7, 1879. Present Dr. George P. Swift, who was also the attending physician; Drs. Osborn and Gregory, and Mr. Wm. Bryan, medical student. The usual preparations having been made, an incision five and a half inches long laid open the abdominal cavity and exposed the tumor. A sound passed between the tumor and the abdominal wall detected firm parietal adhesions on the right side, comparatively few on the left; and deep down in the pelvis there seemed to be either extensive pelvic adhesions or else an unusually broad base-a point that could not be determined at this stage of the operation. A large Hutchinson's trocar was then thrust into the tumor, but the pressure from within split up the opening made by the instrument, and the fluid gushed out in a stream that was beyond control. By inserting my fingers into the tunior, and holding the lips of the rent in firm contact with the sides of the incision, while my assistants turned the patient so far over that everything must run out and nothing could run in, not a drop of the fluid entered the peritoneal cavity. When the tumor was thus emptied of its most fluid contents, I attempted to draw it outside of the abdomen, but found this to be impossible. I detached the adhesions on the left side, without any effect in moving the tumor. Attacking the adhesions on the right side, I found them very dense in the neighborhood of the former tappings, so that they had to be divided with the knife or scissors. Other adhesions, of less extent and firmness, were stripped off from the tumor until it seemed that sufficient detachment had been made to enable me to lift the base of the tumor to the external wound. It was still impossible, and so I passed my hand into the tumor and broke up a large collection of secondary cysts containing colloid matter, in order to so diminish the size of the tumor as to enable me to get at its base. In this procedure, however, I was unfortunate enough, in attempting to rupture a cyst, to make an opening, through which colloid matter, to the extent of over a pint, escaped into the peritoneal cavity. A careful examination made it evident that the trouble was at the base of the tumor, and much more serious than I had anticipated. Passing my hand in the peritoneal cavity down to the base of the tumor, I found it had no pedicle, properly speaking. It seemed to spring from nearly the whole of the broad ligament on both sides, and in the centre of this broad base could be felt a hard fibrous body, that was prob ably the uterus. Then, inserting my hand inside the tumor down to the very bottom, I felt the projection of a hard body, the shape and size of the fundus uteri, rising into the tumor about an inch and a half. While one hand grasped this body, I inserted the other into the vagina, and, by conjoined manipulation, demon

* Read before the N. Y. Medico-Chirurgical Soc., Nov., 1879.

uterus, had spread over the broad ligament of the other side, and incorporated the other ovary in its growth.

The method of enucleation was the only way by which the tumor could be removed, and it was put in practice at once. Beginning as low down toward the base as I conveniently could, determining the point somewhat by the size of the vessels contained in the cyst-wall (about four inches above the base of the tumor), I carefully dissected up an edge of the peritoneal investment all around the tumor. Then I carried the process of enucleation down on one side of the tumor to its base, over the uterus and broad ligaments, and up on the other side until the whole mass was detached and removed. During the process of enucleation there was considerable hemorrhage, and the blood escaped freely into the peritoneal cavity, but there were no arteries of any size, and I could find no occasion for more than four or five silk ligatures which were applied upon such of the adhesions as seemed to possess a dangerous amount of vascularity.

The cavity of the peritoneum was then cleansed with soft sponges, wrung out in carbolized water, and this process was done with more than usual care, because the amount of colloid matter and blood that had escaped during the operation seemed to insure the occurrence of septicemia. I am positive that a considerable quantity of blood and colloid matter must have escaped the cleansing process, and remained in the peritoneal cavity, in spite of the time and care I bestowed upon it. In fact I have yet to learn a method that will remove colloid matter thoroughly and safely when it has been poured over the intestines. The enucleated cyst-wall had stopped all oozing of blood, but it did not seem to be a very promising portion to retain in the abdomen, for its inuer surface was covered with coagulated blood, and at its base was the uterus, apparently denuded of peritoneum and covered with coagula. The appearance was really worse than the fact, for I had removed all coagula that could be safely detached from these surfaces.

There was nothing else to do, however, and so I inserted a large glass drainage tube, not into the enucleated cyst-wall, but behind it, in Douglass' culde-sac, with its external orifice at the lower angle of the wound. All the ligatures were cut short, and the wound closed with silk sutures in the usual manner.

The estimated weight of the tumor was between fifty and sixty pounds. The cyst, emptied of its contents, weighed five and a quarter pounds.

The after-treatment of this case, which was conducted to a successful issue by the skill and judgment of Dr. Swift, was in some respects peculiar. No morphine was given, nor anything to confine the bowels. She was allowed to urinate, without the introduction of a catheter, from the second day on. The tube was retained three weeks; the stitches for fourteen days. This long retention of the tube was due to the fact that we apprehended septic fever as a necessary sequence of the escape of foreign matter into the peritoneal cavity, but the temperature never rose above 102, and her progress toward recovery was uninterrupted. Chloroform was used, but there was nausea afterward, although the operation occupied over two hours.

no

BURNS.-Experience is claimed to have shown that the Bi-carbonate must be employed in saturated solution, ice-cold. Any deviation from the above is responsible for failure.

CASES FROM PRACTICE.

BY G. BUCKINGHAM SMITH, M.D., NEW YORK. Mrs. J. C. B., aged 58, tall, slender, light eyes and hair, skin dry and wrinkled, had suffered from constipation of the most aggravated form for about twelve (12) years. The bowels were not moved oftener than once in two weeks or a month without the use of violent cathartics or enema. Appetite small, but taste of food normal. No bloating of abdomen or any other unpleasant symptoms, except terrible back-ache, with protruding hemorrhoids of a dark purplish color, without much bleeding. Had passed her climacteric without any unpleasant symptoms.

Saw the case first on the 19th of July; gave one dose, in office, of Plumbum m., 3d, to be followed by Esculus h., 1st, in alternation with Collinsonia c, 1st, two powders of each per day, taken as follows: Esculus h. before breakfast and dinner, and Collinsonia c. before lunch and at bed-time; medicine enough to last a week.

Monday, July 28, reported very much improved; bowels have moved every day since the third day after beginning treatment.

Continued same medicines, with the addition of three powders of Sulphur, 3d, before beginning on the Esculus and Collinsonia; medicine to last a week to be taken as before. Reported at the end of the week bowels moving every day, hemorrhoids almost entirely disappeared, no pain in the back, and a desire for larger quantities of food than she had taken before. Continued same treatment, except that only two doses of medicine were given each day- Esculus before breakfast, and Collinsonia before retiring; medicine to last two weeks, as the patient was to leave for her home in the northern part of the State. No further medication. Had report of case about the middle of October. Bowels moving every day; no pain in back; hemorrhoids disappeared; appetite good; don't care to take any more medicine, as she considers herself

cured.

Mrs. H., aged 36, blonde, large, full blue eyes, and brown hair, skin extremely white, in perfect general health, weight about 163 pounds at the time I first saw her, had suffered from gall stones from about her 30th year. Had been treated by a number of allopathic physicians for neuralgia of stomach, neuralgia of intercostal muscles, etc., etc., without results, except to disgust her with the whole fraternity of doctors. At last some one suggested that she might have gallstones, and on that suggestion she underwent the usual course of iodides, bromides, nitro-muriatic acid, etc., etc., besides drinking quarts of olive oil, without any improvement of her condition except as to flesh. The oil made fat, and as she gained in adipose, her difficulty increased. As there was no improvement in her condition, she gave up treatment, and made up her mind that some day a stone too large to pass would get into the duct, lodge there and cause her death.

I was called to her in May, 1876, and found her suf fering from the passage of a stone. I immediately gave China, 3d, which relieved her sufferings materially, as she said, "That was a small one, or else your medicine helped me." As I had faith not larger than a grain of mustard seed, I said very little about the action of the drug, but told her all I knew of its action, and proposed to put her under treatment continuously and see what would be the result.

Up to this time she had been having a recurrence of pain and passage of stone sometimes as often as every day, and never being free from a recurrence more than a week or ten days at the longest, the attacks sometimes lasting three days before relief was obtained by the passage of the stone. I put her on China, 3d, a dose three or four times a day. The dose was one

lozenge properly saturated. This treatment was continued for at least six months, and during that time the passage of the stones became less frequent and painful, until they ceased altogether. She has taken no medicine for over two years, neither has she had any of the old trouble.

I think it fair to pronounce the case cured, as there have been no signs of the disease for twenty-four months or more.

RETENTION OF URINE.

BY J. C. SHAW, M. D., EAGLE BRIDGE, N. Y. Mr. H., age fifty years, received a fracture of the femur, lower third. After reduction of the bone there was retention of urine, for which the usual remedies were given; hot fomentations applied, too; of no avail. The difficulty was not overcome until the introduction of ice into the rectum, about the size of an acorn, and torm of an elongated oval, which I passed beyond the sphincters. In ten minutes, urethral spasm ceased and urine passed freely.

A CASE FROM CHARITY HOSPITAL, BLACKWELL'S ISLAND.-Three weeks ago Mrs. Sheridan, who resided at Fifth avenue and 146th street, was, as she alleged, kicked in the abdomen by her husband. She was removed to the Charity Hospital on Blackwell's Island, where Dr. Eastbrook had her cared for. Last Friday the Coroner's office was notified that she was dying, and, upon the strength of her ante-mortem statement, her husband was arrested and confined in the Tombs. Finding that it was impossible to save her life, the medical staff concluded to perform an operation by which the woman would be delivered of her unborn babe. This operation took place, and the child was brought into the world by the "Cæsarian operation." Shortly after the operation the woman died. Her body was removed to the Morgue on Tuesday, and accompan ing the remains was a death certificate, which stated that the cause of death was puerperal fever. Nothing, however, was said regarding the fate of the child, and Dr. Cushman could not learn whether it was born alive or dead. Yesterday morning he made an autopsy of the body with the most astonishing result. He discovered another unborn baby, which evidently had been overlooked when the doctors relieved the mother of the first child. Baby No. 2 was well formed and large, and when alive must have been healthy. There was no appearance or indication of puerperal fever, but instead there was a malignant form of Bright's disease. There was no evidence of Dr. Cushman violence, externally or internally. therefore believes that the woman made a false statement when she charged her husband with having kicked her.-Herald.

OBSTETRIC FORCEPS.-Dr. A. H. Smith, of Philadelphia, takes the position that, for the safety of the mother and the child, the obstetric forceps should be kept in median line, and should not receive any lateral or pendulum motion. Dr. Smith regards the leverage power of the forceps as a most dangerous delusion, and that as an aid to the traction efforts of the forceps it had no foundation in fact.-Obst. Gazette.

TO PREVENT BOILS.—A very simple remedy is made known by Dr. Seiren, in a St. Petersburg journal, for preventing the development of boils. He states that if the skin is superficially scraped with a small knife, so that a drop or two of blood may be pressed through the epidermis as soon as the peculiar stabbing or pricking sensation and slight induration announce the commencement of the boil, it will not be further developed.

The Homœopathic Times.

A MONTHLY JOURNAL

because a feed expert had a theory of his own, not always founded, however, on sound scientific deductions from facts. In the murder case in Connecticut, which has for so many weeks dragged its weary length along, every one has been struck with the

Of Medicine, Surgery and Collateral Sciences. bewildering testimony of scientific experts, and the

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conclusion is strong in many minds that, if the prisoner escapes conviction, it will be through the scientific fog raised by the prosecution. Jurors are only human, and we must expect, when we see such an avalanche of scientific detail rolled upon them, that,

Office, 18 West Twenty-third Street, New York, at the end of the trial, they will either be in an ad

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vanced condition of dementia, or in a high state of acute mania. No member of the legal profession can be expected to master all the minute details of every scientific specialty; and when he pits one expert against another, as he is often obliged to do, it will require all his legal skill, and all the wisdom of the court, to prevent the minds of the jury from becoming confused. The only safety for a medical expert is, before he advances an opinion, to study his case carefully, and, divesting his mind as much as possible, confine himself to legitimate deductions from present scientific facts.

STATE INSANE ASYLUMS.

The great public is in a periodical state of grumbling at its public servants. This, in one sense, is a healthy condition, of society; for, when a public man knows that some time or other he will have to pass under fire, he is pretty sure to be always ready for a thorough investigation. Just now the public press is hurling its thunders at the State Insane Asylums, and calling for a thorough legislative investigation of these institutions. If any public institution in the State is hedged round with stronger safeguards or more judiciously managed than its asylums for the insane, we have to hear of them. The superintendents, without exception, are gentlemen of culture, refinement, and in point of scientific attainments will compare well with the heads of any medical institutions in the world. Errors of all kinds are carefully guarded against, and the workings of the institutions are as perfect

MEDICAL AND SCIENTIFIC TESTIMONY. A medical man, or a specialist in any department of physical science, may be placed upon the stand as an ordinary witness, in which case he is subject to the rule governing all witnesses, and is required to state simply what he knows, what he has seen or heard, with no more latitude of opinion than any other witness. When, however, he is called upon as an expert, the case is different. Here he is expected to give opinions and the reasons for his conclusions. Of course the value of the evidence depends, in a great measure, upor the honesty and intelligence of the witness. When we take into consideration the fact that ordinary juries are generally men of no particular scientific attainment, we can easily understand how an expert, fully conversant with his subject, with a theory in his mind-perhaps as competent medical officers and zealous, watchright, and perhaps wrong-could impress his own ful trustees can make them. In every ward of the convictions on their minds. They are dazzled with asylum letter-boxes are placed, which can only be scientific terms of which they are ignorant, and by opened by the Medical Committee of the Board of evidence the full force of which they cannot ap- Trustees. Into these boxes patients can put any preciate. In more than one case, where the statement they choose, and we can answer for question of insanity is at issue, and where Middletown, that four times a year these boxes are the lines are so sharply drawn that life hangs opened by the proper authority, and every paper upon conclusions drawn from minute points, carefully noted. The medical officers form their there is every reason to believe the scale has own opinions of the sanity of their patients, and been turned to the death side by theoretical any attempt at imposition will sooner or later come reasoning of so-called experts; and in more than to grief. We assure the public that the State has one case, also, the guilty has escaped punishment already taken every necessary step for the proper

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