stitches completed the operation. Calendula dressings
were applied, and the patient made comfortable in bed.
He was weak, but said that he felt better. We gave
him Arnica internally. I saw him again at five o'clock
in the afternoon. He was pale, restless, almost pulse-
less, and tormented with thirst for cold water, drinking
every few minutes. I gave Arsenicum, and went away
feeling certain that I should not see him again alive.
My misgivings proved correct, for death occurred at
about one o'clock in the morning of the 26th. When I
next made my morning visit decomposition was well ad-
vanced.
Death was considered due to mortification, and the

brought home in a carriage, and a physician immedi-and the process of reduction carefully finished. Twelve ately summoned, who gave a draught of chamomile tea, and endeavored to reduce the hernia by taxis. His rude and miscellaneous handling brought no relief, but inflammation and tenderness constantly increased. About midnight he ordered a flaxseed poultice to be applied and went away, not saying when he should return. Then Dr. Krause was called, who, upon examination, saw the state of affairs, gave Nux comica, and by his request I was called, arriving at the house about 4 A. M. The gravity of the case was apparent. Nausea and vomiting had lasted several hours, together with sharp pain and tenderness in the tumor and adjacent parts. The viscus had enormously distended the scrotum, which with the penis had become livid. A careful measure-certificate rendered accordingly. ment of the surface of the hernia gave the following dimensions: vertically, 14 inches; transversely, 15 inches; circumference, 22 inches. It was tense, unyielding. I next brought Tieman's bottle aspirator into requisition and drew 12 ounces of dark blood and serum from three or four punctures. This relieved the pressure considerably, but not the stricture. Remembering that cold applications will sometimes prove efficacious in such extremities, we applied cracked ice freely but unsuccessfully.

I have reported this case to bring to notice its peculiar featur s, especially the sudden development of the size, the action of chloroform, and the extensive incision required to relieve the strangulation.

I should like to know if any of my colleagues have met with similar experience. Read before The Homeopathic Medical Society " of the County of New York.

LOSIS INVOLVING THE CHOROID.

But one resource was now left to us-the knife-and A CASE OF GENERAL MILIARY TUBERCU I proposed herniotomy, considering it our duty to leave nothing untried which held out the slightest hope of saving life, although I confessed that the man's chances were small. To this Dr. Krause and the patient assented and requested me to proceed.

The hair being removed from the path of the knife and the man placed in position, Dr. Wildes, who had kindly consented to produce anesthesia, applied his ear to the chest and pronounced heart and lungs sound.

BY EDWARD L. HOLMES, M. D., CHICAGO.

Patient about thirty-five years of age.

Miliary tubercles were found in nearly every organ of the body. In this specimen eight minute white elevations are perceived in the posterior half of the choroid. The principal facts regarding the condition of choroid are as follows:

1st. So far from being rarely found in the choroid, miliary tubercles find in this membrane quite a favorite locality for their development.

2d. They vary in size from one-third of a millimetre to two and one-half millimetres in diameter. As they are usually located in the posterior portion of the choroid, they can be recognized by means of the ophthalmoscope during life.

made.

As far as I know, however, the patients have all been on the verge of dissolution when the examinations were 3d. In no case of extensive cheesy masses, confined to the lungs and abdominal organs, are tubercles found

He folded a towel for the anaesthetic in such a manner as to admit air, and I poured upon it about two fluiddrachms Squibb's chloroform, and directed the patient to breathe deeply. He had scarcely taken a dozen whiffs when he was suddenly seized with violent opisthotonos, making a rigid bow in shape from head to heels, with his eyes rolled upward, cessation of pulse and respiration, and the heart working but feebly. The chloroform being removed, the untoward symptoms subsided. Thinking that perhaps we had seen the usual stage of excitement in a high degree only, we tried the chloroform again, but this time with similar bad symptoms, only worse, thoroughly alarming us, and necessitating efforts at resuscitation. Chloroform was now condemned, and not caring to induce the vomiting and trembling of ether I asked him if he would keep perfectly quiet while I should inflict great pain upon him. He bravely responded that he would, and I immediately commenced to make an incision. The patient was as good as his word, never once flinching throughout the operation. Layer after layer was carefully divided, the cremaster muscle presenting a beautifully distinct looped appear-young, or too near death to express complaints regarding ance when brought to view, and much bloody serum escaping when the hernial sac was laid open.

About twenty-six inches of intestine were exposed, of an even, black walnut hue. With my left index finger I sought the point of stricture, which proved to be at both rings, and throughout the entire length of the canal. The strangulation was excessive, and required an incision upward of about eight lines. While completing this extremely large incision, I could feel the pulsations of the epigastric artery, and was thus enabled to keep the knife from it with more certainty.

The intestine was now minutely inspected to see if it

were in condition to be returned to the abdominal cavity. Soon the circulation began to improve, and the black walnut color gave place to a more natural one. A small patch was found mortified, however, which, opening, freed the bowel of a share of its contents and facilitated subsequent movements. A carbolized ligature was then applied to the mortified part, the intestine and wound carefully cleansed with a dilution of Carbolic acid,

in the choroid.

roid, they are of the miliary form and are present in 4th. When tubercular deposits are found in the cho"almost all the organs of the body," and especially in the meninges.

have been observed. The patients have been either too 5th. So far as records state, no subjective symptoms

disturbed vision. Theoretically, alterations in the choroid, crowding upon the retina, especially near the macula, must cause distorted vision.

6th. Cohnheim and Graefe have shown that Guinea

Pigs, inoculated with tuberculous substance, died after a few weeks, tubercles being found in the choroid as well as in many other organs.-Chic. J. & Ex.

mint.

Iodoform. The very unpleasant, pungent odor of Lodoform can be completely masked by oil of pepperFor instance, Iodoform, 2.0, Vaseline, 30.0, up with six drops of oil of peppermint, make an ointment with a pleasant aromatic scent.

rubbed

RETRO-ESOPHAGEAL ABSCESS. June 11th. Obstruction to the passage of food into the stomach. Pain became excessive. The patient said she felt as if there was a large swelling in the esophagus. In a short time she began to vomit, and everything taken into the stomach was rejected. It was supposed that she was suffering from cancer at the cardiac extremity of the stomach.

July 11th. Vomited about a pint of sanguineo-puru- them to be given at the freezing point, but this extreme lent matter. She had also several purulent discharges cold we have always found to disturb the patient's nerfrom the bowels. vous system.

58

respiratory centre is at last paralyzed.
Small doses increase, and large doses diminish reflex
excitability; repeated hypodermic injections of small
amounts have the latter effect.

Large doses antagonize the irritability of strychnia poisoning. But its most important action is on temperature, though for this purpose it must be inhaled in a vaporized form, and not given by the stomach. By the former method, temperature may be reduced 8°, while by the latter it cannot be lowered more than 2 Centigrade These experiments were made in rabbits and other animals.-(Chicago J. & Exam., March, 1879.)

JABORANDI.-Dr. Baker in a carefully prepared paper on Jaborandi in puerperal albumenuria, in which several clinical cases are cited, expresses the conviction that its utility in the treatment of this condition is more than doubtful, and that given after puerperal convulsions, its depressing influence and action, which is continuous and exhausting, prevents sleep and thus renders it in these cases an unsafe and dangerous remedy.

A NEW ANESTHETIC-A committee of the British Medical Association have been directing their attention to the discovery of an anesthetic free from the danger of chloroform, and more prompt in action than ether. They report favorably of two-the isobutyl-chloride, and the chidine-dichloride with which they have obtained very satisfactory results.

a

copious lather. After keeping up the friction four or five minutes, wash out the hair and dry carefully. Afterward, to prevent the parts becoming dry, rub on a little vaseline. At first the hairs may fall out more rapidly, but these are only the dead ones, and need produce no alarm.

CHLORAL HYDRATE IN OBSTETRICS.

A case of considerable duration that occurred some years ago, in which I proposed to help the sufferer to a little respite, by giving a moderate dose of the drug, and, instead of accomplishing my purpose, it set the pain to " grinding" with redoubled vigor, and ended in a far more speedy recovery than had been anticipated. After that it was administered again and again to test this property with most gratifying results, since which time Ergot has been appealed to but once. Puerperal convulsions, by the use of Chloral, I have no trouble in controlling, either before or after delivery. Convulsions facilitated. are stopped at once, and an easy and natural delivery is

This remedy has several distinctive features that commend it to the profession:

First, its simplicity; second, its certainty; third, its innocency with its promptness, and last, but not least, its dual property. It subdues the convulsions and facilitates delivery, when they occur ante-partum.

I give, to arouse to energetic action, the uterus that is inert, 20 to 30 grains, in, say one gill of water made pretty sweet, and have never had to repeat.

TREATMENT OF FISTULA IN ANO-A NEW METHOD.

I. J. SUGGS, M. D., OF TEXAS.

BY

CROTALUS POISON.-M. De Quatrefages presented to the Academy of Sciences at its last sitting a note from M. Lacerda relative to some researches he has been I conceived the idea of introducing a tube into the making at Rio de Janerio into the action of the venom of the rattlesnake. Hitherto the general belief has been rectum so as to prevent the action of the sphincter, and that the poisonous matter secreted by certain species of thereby allowing the fistula to heal. Tube made as folreptiles was nothing more than a poisonous saliva, act-lows: 3 inches long, about 14 inches in diameter at the ing in the manner of soluble ferments. His investiga-point, larger at the base; flared some small holes in the tions, however, show that the matter in question con- base, so as to confine it with a bandage; made an obtains what is called figured ferments, the analogy of turator similar to that of a speculum uteri. After having From a the bowels well evacuated, the tube was introduced and which with bacterides is very remarkable. young and vigorous crotalus, subjected to the action of confined with a T bandage, the obturator removed, and a plug of cotton introduced, the fistula well cleansed, and chloroform, he obtained a drop of the venom on a chemically clean piece of glass, and at once placed it diluted tincture of iodine injected. Almost immediately he observed under a microscope. the formation of a filamentous pulp of an arborescent disposition. Gradually the thickened filament, after having pushed out spores, dissolved and disappeared, and the liberated spores swelled and enlarged visibly, each of them sending out a minute tube, which lengthened rapidly. After a very short period the latter separated from the first spore and constituted another nucleus for engendering the deadly contamination. In the examination of the blood of animals killed by the bite of one of these snakes M. Lacerda noticed that the red globules of the blood commenced by presenting some small brilliant points on the surface, which spread with great rapidity, and ultimately the globules melted one into the other, forming a sort of amorphous paste, Other which could no longer circulate in the veins.

animals in which that blood was injected immediately after the death of the first expired in a few hours, presenting all the symptoms of having themselves been bitten, and their blood always showed the same alteration. M. Lacerda concludes by stating that numerous experiments have shown that the true antidote for serpent poisoning is the injection under the skin of alcohol, or its administration by the mouth.

ALOPECIA BALDNESS.-Kaposi, in the second volume of Hebra's treatise on the skin, recommends equal parts of sapo viridis and alcohol in something like the following formula: Sapo vir., two ounces; alcohol, two ounces; on lavender, two or three drops. This makes an orange colored liquid, with a pleasant odor. Rub upon the parts night and morning, wetting first with Sharp friction with the fingers produces a

water.

Five days after the operation the tube was removed and the fistula perfectly cured.

CHLORAL IN PUERPERAL ECLAMPSIA.

FIELD, M. D.

BY M. W. WAR

Primipara, æt. 35, has suffered from nausea and vomiting during the whole period of gestation. Analyzed the urine, suspecting albuminuria, but obtained only negative results. Face swollen and purple; eyelids puffy, lar, rigid. Head presenting in first position. The pains hands stiff. The os was dilated to the size of a half dol were regular.

The case progressed without accident. Was suddenly seized with a violent convulsion.

I attribute my success in the above case entirely to the free use of Chloral Hydrate.—Med. Times.

TREATMENT OF LUPUS.

Ungt. Hydrarg Nit., 3j, Cosmoline 3j, recommended by Dr. G. McConnell, Med. and Surg. Reporter, Sept. 21st, 1878. The sore healed rapidly, and in ten days treatment is to stimulate the vessels supplying the parts, from application the man was at work. The object in so as to substitute active, healthy action, for the sluggish, indolent condition always found in lupus; therefore your paste should be sufficiently strong, and applied long enough to set up considerable inflammation, and to penetrate through the diseased to the healthy tissues, so that when your eschar comes off it may take the whole of the diseased part with it, otherwise you may have to make more than one application.-Dr. Alexander, in Med. and Surg. Reporter.

faith, and the materialism and crude theories of the past are vanishing before the philosophical and logical principle of Similia, called, it may be, by different names, reached by different paths, yet essentially one and the same. Scarcely a medical book of any school has been published during the past ten years in which there has not been a leaning towards the new philosophy, with gleanings from our Materia Medica, and a redis, covery, with a flourish of trumpets, of truths old to us, which had long since entered into our daily work.

The great world of scientific medicine is moving on,

Office, 18 West Twenty-Third Street, New York. slowly it may be, yet with an irresistible strength and

NEW YORK, JUNE, 1879.

"A regular medical education furnishes the only presumptive evidence of professional abilities and acquirements, and OUGHT to be the ONLY ACKNOWLEDGED RIGHT of an individual to the exercise and honors of his profession."--Code of Medical Ethics, Amer. Med. Ass., Art. iv., Sec. 1.

OUR NATIONAL CONVOCATION.

The meeting of the American Institute of Homœopathy at Lake George will give a good opportunity, not only for presenting in a condensed form the ripe experience of the most practical workers and the best thinkers in our profession, but for marking out a plan for carnest work in the future in the cause of progressive science. The American Institute, notwithstanding it is the oldest national medical society in the United States, and

power. It remains to be seen whether we, the pioneers of the new philosophy, who have borne the heat and burthen of the day, shall be outstripped in the onward march. We may yet live to see the time when we shall find the very weapons we have used snatched from our hands, and wielded with a vigor and intelligence which will place those who have been our adversaries far in advance of us in carrying out the same principles for which we have so long worked, and in strengthening with new facts and careful resource our scientific therapeutics.

If we would hold the vantage ground we have obtained, and still stand in the front rank of scientific medicine,

our National and State Societies must be conducted with

The greatest drawback to the triumphal progress of our cause is to be found in the wild reasoning and absurd pretensions of men in our own ranks. It is this more than anything which has drawn forth the ridicule and misrepresentations of our opponents, who, notwithstanding their sneers at our school, are steadily absorbshould be the most dignified and progressive, has grad-priating the vast wealth of our Materia Medica, with ing the great principles of our theraupeutics and approually lost sight of the great object of its formation, frit- valuable scientific additions, to their own use. tering away its time in non-essentials and in discussions, much of which were void of interest and point, and beneath the dignity of what should be a great scientific organization. Instead of taking an advanced position among the scientific bodies of the world, making itself more wisdom than has heretofore marked their course. felt and respected everywhere by the originality of its The truth of the great principles of our faith are dawnwork and its progressive spirit, it has lagged in the backing upon all minds, called it may be, by other names. ground, only here and there a grand movement or a than ours, seen often dimly and through the mists of brilliant thought flashing out from a mass of verbiage early training and previous prejudices, yet it requires and platitudes. The American Institute was organized no prophet's eye to see that the great principles of a by earnest men, fully comprehending the noble work in scientific theraupeutics will at no distant day-a day which they were engaged, and earnestly believing the which may be seen by some now living-stand out so new philosophy would elevate therapeutics from its clear and distinct that they will become a bond of union between earnest, honest, truth-seeking minds in all empirical condition to the dignity of a science. They hoped that an organization which would bring together schools and of every faith. It remains for us to say men from all parts of the country, united together by a whether in this mighty awakening in which old idols are common faith, would be an immense power for good, being broken and trampled under foot we shall march as and show to the world the grand results of united work the advance guard of progress, or buried in sloth, fighting in a great cause. That homeopathy has taken such about non-essentials, defining the difference between high rank throughout the country and has accomplished tweedledum and tweedledee, drift idly in the past, while so much in establishing a scientific therapeutics, which the mighty current of human thought sweeps over and The great obstacle to progress, in which is rapidly being adopted by the whole medical world, is beyond us. due more to the inherent power of a great truth work- our own profession and school forms no exception, has ing silently like leaven through all medical philosophy, ever been the failure to utilize the truths obtained by than to any united action or strong effort on the part of careful thought and long and earnest labor. Not unsocieties, National or State. frequently has a victory gained by persistent effort, by patient and unwearied determination been frittered away in wild and often puerile theorizing, and in a rash display of bigotry and intolerance. The National Society, composed of members from every part of the country, should,

We can look to-day with a feeling of pride to the strong evidence of the adoption of the great principles of the homeopathic faith by the leading medical minds of the world. All are gravitating towards a common

by the strength of its deliberations and the wisdom fit-a proceeding liable to jeopardize the good name of the school as well as some institutions--and thus prevent positions of honor from being occupied by those who, from education and experience are eminently worthy of the confidence and trust of the community. The day may come when the trustees of some of these institutions will be brought up with a round-turn by the doings of some of these incompetents, and be surprised to find that they have not exercised due care in the selection of their medical officers.