to this; and the result was very satisfactory, the pulse having fallen to 88 the day after treatment was begun, while the recovery altogether, including the absorption of the blood, was unusually quick. The development of the physiological symptoms of Belladonna was unexpected, and obliged me to stop it, and give Mercurius corr. instead. After the cure of the pelvi peritonitis, Arnica was given with the view of promoting the absorption of the blood, which, as I have already observed, was accomplished unusually quickly. The employment of surgical interfe rence in the shape of puncture is condemned by most gynecologists, unless other treatment should have failed. It is, in fact, considered a dernier ressort, and is only justifiable when either the amount of blood effused is so large as to press much on the rectum behind and on the bladder in front, through the medium of the uterus which is driven against the pubes, or when, instead of absorption occurring, suppuration ensues with distinct fluctuation. The onset of suppuration is indicated, of course, by shivering and hectic fever, with its concomitants of loss of flesh and health. (D. Dyce Brown, B.J.H., Jan., 1876.) Sub-Peritoneal Hæmatocele. with Secale 9. (O. W. Lounsbury, C. M. A., p. 81.) Peritonitis. - Cured Aconite, Belladonna, Bryonia, Rhus tox. (F. Ladelis, Riv. Omiop. Roma, v. 22, p. 145.) Tubercular. Cured with Iodine 2. (Revue Hom. Belge, 1876, p. 81.) (Dr. Anillot, Trans., H. W., vol. XI., p. 260.) Hair in the Female Bladder. Mass of hair, apparently of ovarian origin, removed per urethra. (A. O., 1876, p. 293.) Electricity in Enuresis. The induced current is applied indirectly to neck of bladder. through a brass rod in rectum or vagina, which is connected with one pole; the other pole is applied to pubes or thigh. This treatment, continued for from four to six weeks, has proved very beneficial, both in children, and in women suffering from incontinence as a result of confinement. (A. O., 1876, p. 428.) MAMMÆ, Preventing the Secretion of Milk in the Female Breast. A new method, either where it is found necessary to wean the child from any cause, or after a stillbirth: Take a piece of adhesive plaster ten inches square, round the corners, and cut a hole in the centre for the nipples; then, from the centre of each corner make a straight cut toward and within two inches of the centre hole; place the woman on her back, and apply your plaster, the lower corner first then the upper, on both sides, and over this two other straps two inches wide and eighteen long, to support covering over the clavicle in one and shoulder in the other. This mode of treatment will prevent mammary abscesses, if resorted to in an early stage. (J. W. Lane, M. I., vol. III., p. 270, 1876.) On Detection of Mercury in Human Milk during Inunction with Mercurial Ointment. Unequivocal proof of the existence of this condition was obtained in a woman under treatment for syphilis. Syphilitic symptoms in the child disappeared during inunction treatment. (A. O., 1876, p. 434.) Milk, Scorched Batting to Suppress. (D. B. Marrow, C. M. A., p. 430.) Female Breast. May be extirpated for neuralgia and hardness following childbed. (Nussbaum, M. I., vol. III., p. 134, 1876.) Ung. hamamelis will dry up the secretion of one breast, when applied to only one without interfering with the other. (R. W. Lansing, H. W., vol. XI., p. 386.) Breasts. Ung. hamamelis will dry up and stop the secretion of milk in a breast and prevent an abscess. (R. W. Nelson, M. I., vol. III., p. 530, 1876.) Mammary Glands. Graphites in induration and cicatrization of the mammæ. (D. B. Whittier, Mass. Trans., vol. IV., p. 690.) Treatment of. (G. B. Sawtell, N. E. M. G., vol. XI., p. 398.) Graphites in Induration and Cicatrization of the Mammæ. I have had many cases in which Graphites has been effective, and I confidently resort to it now for the removal of indurations from the mammæ. (D. B. Whittier, N. E. M. G., vol. XI., p. 395.) Mammary Abscess in cellular tissue around the nipple; red streaks run across the gland toward the axilla; very sensi tive at the nipple; it will suppurate. R., Bell. 3 and poultice. (R. Ludlam, M. I., vol. IV., p. 280, 1876.) Phylolacca root bruised and applied as (H. Tumors of the Mammary Gland; Carbo. an. cured hard tumors of years' standing. Calc. carb., soreness and swelling before the menses; lumps in the breasts, constitutional symptoms agreeing. Conium, swelling, induration, with tingling and shooting pains. Lycopodium, crawling pains in scirrhus of breast. Conium, lancinating pains in scirrhus. (H. M., March, 1876.) OBSTETRICS. Diagnosis of Pregnancy. Bergeron has observed great abdominal enlargement, flattening of the costal regions, depression of the umbilicus, suppressed menstruation, enlargement of the breasts, with brown areolæ of nipples, morning sickness, sof tening of the cervix, and a brownish line running from the mons veneris to the umbilicus, distinctly traceable, where pregnancy had not occurred. (O. M. and S. R., 1876, p, 162.) The Influence of Phthisis upon Child-bearing. Phthisis has a marked effect upon conception; few women bear more than one child after the commencement of pulmonary symptoms, and a third pregnancy is very rare. In phthisical subjects more than one-third of the pregnant women aborted or were prematurely delivered, and recovering only those who had a tubercular history; in but one-half did pregnancy last till full time. These mothers are unable to suckle their children, both because the symptoms of phthisis were hastened in the mothers, and because the infants showed signs of insufficient nutrition, and died with enteric symptoms if nursing were persisted in. Pregnancy hastens the evolution of phthisis, delivery being rapidly followed by the death of the mother. Both and lactation are exciting causes pregnancy of phthisis in predisposed subjects. (M. F. Ortega, quoted in O. M. and S. R. Nov., 1876, p. 362, from Lancet.) Medical Treatment in Obstetrics. (A. P. Hollet, Trans, N. Y. S., 1876-7, p. 269.) Sudden Effusion of Blood into the Labia of Pregnant Women. Two cases. The tumor increases somewhat in size, is painful; finally breaks or is opened, discharges and heals, leaving no bad results. (A. O., 1876, p. 608.) Milk Diet in Albuminuria of Pregnant Women. (Le. Prag. Medicale, N. E. M. G., vol. XI., p. 523.) Myocarditis and Pregnancy. In a number of cases of sudden death following confinement, for which no special cause could be ascertained, a post-mortem examination has revealed a violent acute myocarditis with fluidity of the biood, and diminution in number of red corpuscles of the blood. (Dr. Hauber, quoted by T. Rafka, A. H. Z., 92, p. 120.) Varices of legs during pregnancy, cured by Hamamelis. (Dr. Izard, H. M., July, 1876.) Notes on Hemorrhage during Pregnancy. (A. Liliencranz, C. M. A., p. 340.) Pregnancy during Existence of Cancer of Uterus. Child carried to full term; born without unusual suffering; healthy and strong. Four months after confinement the mother died, and autopsy revealed “ an extensive cancerous ulceration of the uterus, intestine and liver," the latter organ being three times its natural size, and a complete scirrhus mass. (W. P. Gambell, Mass. Trans., vol. IV., p. 33.) Ptyalism in a pregnant woman cured by chewing a kernel of coffee. (H. J. Underwood, M. I., vol. III, p. 270, 1876.) Pyrosis of Pregnant Women. Cimicifuga racemosa, 1st, about ten drops in an ounce of water, a teaspoonful every four hours until relieved. (J. H. Smith, Mass. Trans., vol. IV, p. 260.) Vomiting in Pregnancy. Continued nausea, aversion to food, constant thirst, tearing pains, vomiting of ropy mucus indicated Kali bich. She got one dose of the two hundredth potency. The nausea and vomiting were immediately relieved. She had vomited almost incessantly for thirty days. (Wm. A. Hawley, Trans. N. Y. S., 1876-7, p. 122.) Two cases in which perfect success was obtained by the administration of Acidum lacticum and Nux 200. (N. R. Morse, Mass. Trans., vol. IV, p. 8.) Galvanism has been a complete success; five daily applications; positive pole at lower cervex and negative at the pit of the stomach; has cured a large number of cases. (M. Graham, M. I., vol. IV., p. 157, 1876.) Nausea of Pregnancy. Cured by Lactic Acid. (A. M. Cushing, Mass. Trans., vol. IV., p. 497,) Recurrent Abortion from Mal-lactation. A case. Gave Bell., to be followed by Phos. (R. Ludlam, M. I., vol. IV., p. 427, 1876.) Anasarca. Patient æt. 45; after abortion. Apis 1; grain doses crude powder of stings; profuse urination and cure. Patient æt. 70; general venous obstruction and fullness. Apocynum fl. ext., gtt. B, 4, 5, 6, 7, three hours' intervals; profuse urination and cure after the five doses. Patient, a girl æt. 13 months, had not had scarlatina; 6 weeks' unsuccessful allopathic treatment; pronounced incurable. Apis 2 and 30 cured. (I. N. Eldridge, A.. O., 1876, p. 454.) Natural Labor. Mechanical help and appliances in. (W. R. Elden, Part II., C. M. A., p. 403.) Presentations, Shoulder. A case reported by Dr. Maxson. The woman was placed in the "knee-elbow" position, and the presenting 'shoulder was then gently pressed upon and made to recede, when the vertex was grasped by the fingers, and the following pain engaged it in the superior strait, and thus an occipital presentation - was produced. Natural labor followed. (A. O., 1876, p. 583.) Raise the mother's hips to an angle of 90°, and press shoulder until it recedes. This is aided by the relaxing influence of ether, and by manipulating the abdomen externally. (T. E. Enloe, H. M., Oct., 1876.) Of the face. (J. H. Marsden, H. M., Aug., 1876) Prolapse of the Funis During Labor. (O. M. and S. R., 1876, p. 109.) Midwifery. Anesthesia in; a paper on' showing that in cases where Sulphuric ether was used, the uterine contractions continued regular in occurrence and duration, and in some cases the pains increased. All fear from nervous excitement being taken off, the pains were given full scope. No bad results have followed its administration. A case is cited in which she had had pains for 8 hours, and the head had not advanced. Inhalations of equal parts of Ether and fluid extract of Ergot produce marked contractions of the uterus and immediate birth of the child. This treatment has not produced a tendency to post-partum hæmorrhage. (E. N. Harpel, M. I., vol. IV., p. 195, 1879.) Early Escape of Liquor Amnii without labor. Sometimes what is called the false water escapes, and thus confuses again; it may be discharged, and labor not come on for a few days. (R. W. Nelson, M. I., vol. IV., p. 373, 1876.) Premature Rupture of the Membranes and free escape of the liquor amnii. A case in which it occurred forty days previous to labor, caused by over-work, and followed by labor pains and discharge of blood. Sabina Ex stopped them and all went on to full term, when the child was born alive and well. If rupture takes place after the fourth month, and above the lower third, there is a fair prospect to prevent prema. ture labor; if earlier than this, or in the lower third, the chances are against you. (John W. Streeter, M. I., vol. IV., p. 371, 1876.) Obstetrical Notes. Puls. or Caul. If pains Placenta Previa. (G. H. Hackett, N. E. Complicated with uterine hydatids. (E. C. Alarming and excessive loss of blood stopped by perforation of placenta and rupture of membranes, in case where os was not sufficiently dilated to allow of introduction of hand, and where it would have been fatal to woman to attempt forcible dilatation. (W. R. Elder, A. O., 1876, p. 294.) Retained Placenta. The irregular expulsive pains of labor in this case were regulated by Puls. 3, but after birth of child the placenta was retained. Puls. 200 increased the after pains, but at the end of four hours had to deliver with the hand. (C. W. Enos, M. I., vol. III., p. 266, 1876.) Seven children in three years and eleven months, all on the ninth day, of the month and Sunday. (F. Hunt, M. I., vol. III., p. 531, 1876.) Superfotation of Triplets. All died; two had Obstetrical Peculiarities. arrived at full term, the third was eight inches long and was about the size of a three months' fœtus. No autopsy. (Philo. G. Valentine, M. I., vol. IV., p. 485, 1876.) Twins. Both delivered enclosed in a sack. (A. M. Cavan, M. I., vol. III., p. 531, 1876.) More "Siamese Twins." Case reported from Dorchester County, Maryland. Mother, negro; twins, female; bond of union from centre of sternum to umbilicus. One child born dead; other born living, but died in few moments. Beyond the unnatural union, the children were well formed, and were of good size. (A. O., 1876, p. 69.) Labor. Stimulants in. (I. C. Teague, vol. III., p. 61, 1876.) symptom was also noticed, chilly sensa tion, and actual cold rigors when touching anything cold. Arsen. and Salicylic acid were the principal remedies. (E. M. Hale, M. I., vol. IV., p. 548, 1876.) p. 145.) Concerning the Use of the Obstetric Forceps. Prominent among these investigations are those devoted to the long forceps as a dis tinct instrument. This instrument is designed for, and applicable to, cases in which the head will not enter the brim or de-Aluminuria. scend below the superior strait; to cases in which there exists a moderate degree of disproportion between the diameter of the strait and that of the fœtal head; to cases in which, from faulty direction of the head or feebleness of the uterine efforts, the head fails to advance. (J. H. Woodbury, N. E. M. G., vol. XI., p. 245.) Their use with cases. (S. P. Cole, M. I., vol. III., p. 184, 1876.). A paper read before Baltimore Hom. Med. Soc. by Elias C. Price. (A. O., 1876, p. 160.) Labor. Pains ceased (Secale had done no good). Woman felt tired; had frequent faintings and slight twitchings. Copper brought on the pains and terminated labor. (Rodemacher, quoted by W. Sorge, A. H. Z., 92, p. 128.) Casarian Section. Successfully performed by John Parks, of Bury, Lancashire. (Extr. fr. Lancet, N. E. M. G., vol. XI., p. 519.) Silver wire sutures in. (S. S. Lungren, C. M. A., p. 243.) Eclampsia. Confinement in early evening; no unusual symptoms. About an hour afterward she was attacked with severe convulsions; continued every thirty min-1 utes during the night, and in intervals she was comatose, with heavy breathing. At 8 A. M., put ten or twelve drops of Nitrite of amy on a napkin, and administered it by inhalation. Next spasm occurred in fifteen minutes, but was very slight. Inhalation again given. At 'long intervals very slight threatenings of convulsions, but the inhalation promptly checked them. In afternoon she became conscious. (G. Russell, Mass. Trans., vol. IV., p. 647.) Puerperal Mania. A modest, retiring woman was confined, and after eight days she became very gay and lively, with many confused ideas, which she mixed all up without any order or connection. Her look was staring and vacant. After Bellad., Stramon., and Hyosc. had been used in vain, Cupr. acet. helped soon and lastingly. (Georg Schmidt Hygea, vol. XII., 1840, quoted by W. Sorge, A. H. Z. 92, p. 147.) Septicæmia. Six cases; two caused by absorption of purulent matter from lacerations of vaginal mucous membrane, two from decaying adherent portions of the placenta, three unknown. A peculiar (Exchange, H. W., vol. XI., Mrs. M, in a few days after confinement, was attacked with symptoms of puerperal fever; great pain and distress in pelvic region, etc. Electricity arrested all the abnormal conditions in a few minutes. Cured speedily. (W. B Chamberlain, Mass. Trans., vol. IV., p. 367.) Keeping the Bed after Confinement. Dr. Goodell, of Preston Retreat, in Philadelphia, urges that lying-in women be encouraged to get up for good as soon as so disposed. A long and wellsifted experience proves that by such treatment convalescence is rendered far more prompt and sure. (A. O., 1876, p. 68.) Parturient Convulsions. First duty is to protect the sufferer from exposure and personal injury by her violent movements. A hard substance must be placed between molar teeth at the inception of each convulsion, to protect the tongue; hair loosened, and any constriction around neck, chest, or waist, removed; cold applications to the head, and warm ones to the feet; excess of light cut off; all noise avoided; Α all unnecessary attendants removed. case of a woman 40 years of age, five months pregnant, with violent. (M. I,1876.) Post-Partum Convulsions. A Case. Bladder was distended with urine; each time recovered under the ordinary remedies, but with complete agalactia. This was removed by Ol. ricini 1 drachm, and Aqua 8 oz. mixed, and a tablespoonful every four hours. It is always beneficial in agalactia. (R. L. Hill, M. I., Vol. III., p. 265, 1876.) The Inner Surface of the Uterus after Parturition. (O. M. and S. R., January, 1876, p. 38.) Retention of Urine after Confinement. Usual remedies did not relieve; patient became very nervous and regarded it as a continued necessity. Ignat cured at once. (R. N. Tooker, M. I., vol. III, p. 399, '76.) Post Partum Metritis with Peritonitis. Ars." (Wm. A. Hawley, Trans. N. Y. S., 1876–7, p. 122.) 30 Case of Complicated Labor with Subsequent Hemorrhage. Treated by subcutaneous injection of Ether. (Ext. in N. E. M. G., vol. XI, p. 510.) Post Partum Tympanites and Renal Colic. Arnica in. (B. Ehrmann, C. M. A., p. 378.) Spasms Resembling Epilepsy. Bell. 3d cured. (R. L. Hill, M. I., vol. III, p. 328, 1876.) Hemorrhages. China. In women from prolonged lactation; continual sensation of satiety; swelling without colic; easy emission of flatus followed by relief. (Bib. Hom., 1876.) Puerperal Fever. Acon. General inflammatory condition; headache all over; bed seems turning around; is restless and anxious. Gels., great sensitiveness to the light; face flushed; stupor; roused easily, but drops to sleep again; dullness of hear ing; cramp-like pains, extending down the limbs. Verat. vir., patient's system seems shocked; the attack is sudden; great oppression of the chest. Puls., attacks are ushered in slowly; the lochia and milk become suppressed; patient is worse at night; has much backache; pulse small; flesh has a soft, flabby feel. Bell. cases are talkative; chill, heat, and sweat are mixed, and appear first on one part of the body and then on another; sluggish in thoughts; rash-heat troubles; wants to get up; disposed to scold; hysterical cry and laugh. Merc. sol., patient drenched in sweat, especially at night; sore all over; countenance dirty and wan; great pressure in rectum. Bry., high fever all over; dull headache; great thirst; worse on motion. Nux vom., has constipation, with painful irritation; sexual orgasm; craves sour drinks. Rhus., apathetic, dull and listless. (Baer, M. I., Vol. IV., p. 293, 1876.) Did not believe in a distinct fever, but that it was septic. It is of the greatest importance to recognize its early signs of bloodpoisoning. This can be best done by the thermometer. When it runs up to 102° to 103° F., it is time to bring it down. Treatment, Alcohol and Quinine, the former in milk punches made with whisky, and the latter in one grain doses every hour for six or eight hours, thus taking down the temperature, the alcohol antidoting the blood poisoning. Then give the attenuated remedies, Verat. vir., 2d and 6th. (R. Ludlam, M. I., Vol. IV., p. 294, 1876.) Puerperal Convulsions. Spasms com mence with cramps in fingers and toes; bands and feet turn outward. Cuprum, high, one dose, cured. (Gwynn, H. M., March, 1876.) Backache. Nux vomica, worse from turn ing in bed, or pain and lameness rendering turning impossible. Esculus, worse from walking and movement; also, aggravation from standing, and relief from walking. (Dr. Boyce, H. M., March, 1876.) Notes on Tedious Labor. A labor normal in every respect, except that there is, during the first stage, a hyperesthesia or oversensitiveness of the body of the uterus and of the neck. It may render the labor tedious, and often exhaust the strength. The woman tosses about, does not wish to be touched in the abdomen or at the os; is constantly in this irritable condition, with an exocubation at each regular contraction. The remedy best indicated by its pathogenesis is Nux vomica, but I announce preference for the Sulphate of morphia, given in the second decimal trituration or higher. The first centessimal will not do as well. The double trituration seems to be requisite to insure a good effect. A few doses will almost invariably relieve. (A, R. Wright, Trans. N. Y. S., 1876-7, p. 265.) A Novel Treatment of Obstinate Vomiting in Pregnancy. On examination I found the os uteri partially dilated, so as readily to admit the finger. I thought it right to advise bringing on labor without delay. I at once dilated the os as much as I could with the finger. I tried to rupture the membranes, but they were so flaccid, and the head offered so little resistance, that I could not succeed. In about an hour saw the patient again, and was surprised to find that a longer period without sickness had elapsed than before. Waited another hour, and another, and there was no return of the vomiting. She went on to full period of pregnancy. Case No. 2 equally successful. (Ext. in N. E. M. G., Vol. VI., p. 142). Mrs. Primipara, seven months pregnant, after a lingering labor, was delivered, by the forceps, of twins. The first child, a female, was perfect, but owing to longcontinued pressure on the head, gasped but a few times after birth. The second, the male, continued to breathe for an hour or two. The children were contained in separate membranes, and there were two separate placentas. The male was monoculous, a Cyclops, the eye occupying the place in the centre of the face usually filled by the nose, and appearing perfect. The lids were cleft, giving a diamond-shaped opening. The nose was an inch in length, shaped like a proboscis, and located above the eye, hanging over it, so as nearly to occlude it. At the extremity was a small opening into which a probe passed, and through which air passed in respiration. The child was otherwise well-formed. H. Hedenburg, Mass. Trans., Vol., IV, p. 187.) (J. |