grenous and perforated. In 13 cases an incision was made and the pus evacuated, and in 4 the patients had recurrent attacks after incision and drainage. All these cases, with one exception, were of the acute suppurating type of the disease, and all the patients received medical treatment for a period varying from twenty days prior to operation.

Of the 17 cases in which medicinal treatment alone was instituted, 9 were males and 8 females. There were 9 deaths—of males 2, of females 7. The cause of death in 4 instances was septic peritonitis; in 4. rupture of the abscess into the abdominal cavity, and in 1, unknown.

Dr. L. S. McMurtry of Louisville then read a paper, entitled

THE OPERATION ITSELF IN APPENDICITIS,

which will appear in conjunction with other papers read at the meeting in forthcoming issues of the Medical News. Installation of officers-elect then took place, and the meeting was declared adjourned.

Periscope of Medical Progress.

MEDICINE.

CONDUCTED BY JOHN M. DUNHAM, A. M., M. D.

-The

LEUCIN AND TYROSIN IN THE URINE OF ERYSIPELAS.occurrence of these two bodies has generally been looked upon as indicative of severe involvement of the liver, as acute yellow atrophy, phosphorous poisoning, etc. Although and occasionally found in other diseases, severe typhoid, variola, leukemia, rabies, Kirkbride (Centralblatt fur Innore Medicin No. 41. '97). makes the rarity of such findings his justification for reporting the case of an 18-year-old girl with uncomplicated facial erysipelas whose urine contained, in addition to albumin, hyaline and granular casts, leucin and tyrosin which could be demonstrated both chemically and microscopically.

C.

A NEW URINE CONSTITUENT, OXYPROTEINIC ACID.-St. Bondzynski and Gottlieb (Centralblatt fur Medicinischen Wissenschaften, No. 33, 1897,) while studying the urine of a dog with phosphorous poisoning came upon a new acid which occurs also

in the normal human urine. Its name is intended to indicate that it is an oxidations product of albumin. It was obtained by a somewhat circumstantial manipulation in the form of its barium salt, a white hygroscopic powder, soluble in water, insoluble in absolute alcohol. The results of the analysis did not entirely agree, but C43 H82 N14 O31S probably represents the acid very nearly. It can be seen from this complex molecule how near oxyproteinic acid stands to albumin-it is probaly one of the first steps on the way to the well-known end-products of albumin combustion. The acid is present in considerable amounts in the urine, from 2-3 per cent. of the whole nitrogen is in this combination. C.

ARGON IN THE BLOOD.--Répard and Schlösing (Compt. rend., 1897, p. 302,) have shown that argon is present in the blood in the proportion of 2.1 parts to every 100 parts of nitrogen gas. Both nitrogen and argon are equally soluble in water and in the blood. The blood contains about twice as much of both nitrogen and argon as it is capable of dissolving, making it probable that they exist in the blood as chemical combinations. From (Centralbl. f. Med. Wiss.)

C.

SURGERY.

CONDUCTED BY W. J. MEANS, A. M., M. D.

MAMMARY CANCER.-(British Medical Journal, May 29, 1897.) In concluding his lectures on the operative treatment of cancer of the breast, Mr. Bennett May says that "so far as is at present known our only hope of advancement lies in the direction of more thorough and more early operation. The limit of what is possible in the former direction will soon be, if it is not already, reached. The result must carry conviction that we may hopefully anticipate a real cure in at least 30 or 40, or some would say, 50 per cent. of our cases. I would not like to place 30 as a limit, but is with somewhat chastened hope that I look for anything beyond. Longer observation is required, particularly as to the future development of those cases who pass the three-year limit. Even now, however, the operation in too many cases is not practiced to the best advantage, and is not used for all it is worth. Certainly some of the disrepute and prejudice which have surrounded it may fairly be ascribed to the incomplete and inadequate manner in which it is too often done by men who have had no proper surgical training, and whose ill results serve to injure the cause as a whole, and to reflect prejudically on the work of others. The fact is it has been every one's operation because it is

thought to be easy, but now that surgery is specialized to such an extent these happy-go-lucky methods should be abolished in this as in other branches of surgery.

URETHRITIS AND EPIDIDYMITIS AFTER BICYCLE RIDING.— G. Berg (Deut. med. Wochenschr.)—The author reports the case of a man who had never had gonorrhea, but after a ride upon a bicycle was seized with pain on micturition and a slight mucous clouding of the urine. Upon urethroscopic examination a traumatic posterior urethritis was discovered which was supposedly due to pressure of the point of the saddle of the bicycle upon the perineum. The patient yielded to a treatment of rest and diet in a few days, but suffered a relapse as soon as he again ventured to ride his "wheel." In the second case, a vigorous man, without any previous hereditary or personal vices, after a ride upon a bicycle, was affected with left epididymitis, incomplete cure of which demanded a period of more than six weeks.

SKIN GRAFTING.-In a paper presented to the American Medical Association at its recent meeting, Dr. J. Z. Lusk, of Warsaw, N. Y., described a method, which he has devised and employed with great success, which greatly simplifies the process of skin-grafting. He uses epidermis which has been obtained by raising a blister, this blister being produced either by cantharides or as the result of burns or scalds. He removes the cuticle carefully, keeping it flat, and preserves it in sterilized gauze and cotton. The epidermis dries quickly, and after this may be kept in this condition indefinitely. He has used epidermis which has thus been kept for more than a year with perfect success. The epidermis is placed on the granulating surface in the dry condition, care being taken merely to apply the proper surface. He does not change the dressings for several days.

HEMORRHAGE FROM SOUND KIDNEYS.-There are eight cases on record in which the kidney was removed for hemorrhage and found absolutely normal. Klemperer ascribes it to paralysis of the vasoconstricting nerves, which he treats with complete repose, predominant but not absolute milk diet and suggestion. If several weeks of this fail to cure, combined with hydrotherapeutics and local electric treatment, and there is danger from excessive loss of blood, the kidney should be explored, but if found sound it need not be removed at that time, as the exploratory operation alone may bring relief.-Deutsche Med. Woch., No. 8. 1897.-Jour. Amer. Med. Assn., July 3, '97.

DEATHS FROM ANESTHETICS.-The German Surgical Society gives the following statistics for the past five years in regard to mortality from anesthesia: Chloroform was administered 201,224 times, with 88 deaths, or in the ratio of 1 in 2,286; ether, 42,141 times, with 7 deaths, or in the ratio of 1 in 6,020; chloroform and ether, 10162 times, with I death; chloroform, alcohol, and ether, 5.744, with I death; ethyl bromide, 8,967, with 2 deaths. -Medical Record.

OPHTHALMOLOGY, OTOLOGY AND LARYNGOLOGY.

CONDUCTED BY J. E. BROWN, A. M., M. D.

RETROÖCULAR NEURITIS.—Mr. Marcus Gunn (British Medical Journal, March 20, 1897,) in opening a discussion on this subject, characterized retroöcular neuritis as a distinct clinical group of cases and said that, owing to objective signs being not always present, reliance had to be placed on the subjective symptoms: hence the affection was liable to be considered a hysterical one. The action of the pupils, however, was a most important help in the diagnosis, as in hysterical amblyopia the action was unimpaired, while in retroöcular neuritis the pupil was inactive; or where the contraction on exposure to light was normal it was not maintained on continual exposure. Occasionally, one or both optic papillæ were involved, but the changes were never gross. In papillitis, due to intracranial disease, the visible changes preceded the loss of vision, whereas in retrobulbar neuritis failure of central vision was one of the earliest symptoms, the visible changes in the nerve occurring later.

During the stage of swelling in papillitis the conductivity of the nerve was unimpaired; it was only during subsidence, when the exudation was shrinking, that the nerve fibers were compressed, whereas in retroöcular neuritis the pressure on the nerve fibers within the pial sheath, especially where enclosed in the bony optic foramen, produced a very early effect, and was recovered from as soon as the pressure was diminished. One of the most prominent symptoms was the presence of a central scotoma for colors and for light, indicating an affection of the macular fibers. This might be owing to the situation of these fibers in the nerve or to their great functional activity and consequent sensitiveness to pressure; or it might be due to the fact that the principal lymph current traversed the center of the nerve. The periphery of the visual field was sometimes contracted; if this were partial it would be a valuable sign in localizing the lesion; in taking the visual field, care should be exercised in using test objects of a standard size. There was pain on movement, a varying amount of am

blyopia, or even where visual acuteness was not diminished, there was slowness in reading the test objects, which occasionally seemed to be moving; vision was worse in bright light, or after exhaustion or want of food. The sensation of movement of objects might be explained by a breaking up of the medullary sheath, leading to imperfect insulation of the axis cylinders, or by alternating activity of exhausted fibers. The local causes of the neuritis were orbital cellulitis, exposure to cold, general septicemia, periostitis of the optic foramen, extending from the adjacent sphenoidal cells, or the causse might be the local manifestation of a general disease, such as syphilis, rheumatism, or gout, the latter having a tendency to recur. Finally, the optic nerves might be affected as part of the central nervous system. Retrobulbar neuritis had also affinities with toxic affections of the nerve.-Buffalo Medical Journal.

GYNECOLOGY AND OBSTETRICS.

CONDUCTED BY J. F. BALDWIN, A. M., M. D.

STATISTICS.—It has been rumored more than once that certain eastern gynecologists (possibly some western ones as well), who are constantly boasting of their statistics, are in the habit of carefully selecting the cases upon which they operate, and declare "inoperable" cases that they have reason to fear will not result favorably if operated on.

The following is from the April number of the American Journal of Surgery and Gynecology, and details a circumstance which took place at the recent meeting of the Tri-State Medical Society of Illinois, Iowa and Missouri:—

"Speaking of Price and Ferguson, reminds me of a "good one" on the Philadelphian. When Price made his last hysterectomy before the Society he remarked: 'In my last 350 abdominal sections I have not had one death.' An ominous twinkle in Ferguson's eye gave hint to his associates that he was 'loaded.' A few moments later he made a most remarkably rapid, clean and skillful operation upon a woman affected by a suppurating dermoid cyst of the ovary. At the conclusion of the work he said that some operators would refuse to touch such a case for fear of spoiling their records-that she had no chances to live without operation, while she had about 50 per cent. in favor of recovery by operation. 'Do you think she will recover?' asked Price. I am rather inclined to think she will,' answered Ferguson. 'I don't!' said Price. I know you don't' responded Ferguson. ‘I saw you examine her in the ward, shake your head and ask the interne for an easier and safer case!' And then the crowd laughed."