of the pneumogastric nerve, and probably also by relieving the diseased condition of the stomach and bowels, upon which the inordinate discharges depend Bismuth being nearly insoluble, the greater portion of it passes down the alimentary tract, and therefore acts as a local sedative. That these nerve filaments are always in an irritable condition in gastro-intestinal troubles is beyond question. The following is a very efficient prescription: R Bismuth subnitrat., grs. xxiv; zinci oxidi, grs. iv; ingluvin, grs. xij. M. Ft. pulv. no. xij. Sig.— One powder every four to six hours. In cases attended with tormina and tenesmus small portions of morphia may be added to the above pro re nata.

To cases that have persisted for some time, and the evacuations consist of a mixture of feculent matter, mucus and undigested articles of diet, with tumid and tense abdomen. and the body and extremities emaciated and shriveled, I have administered the tinet. chlorid. of iron, two to three drops twice or thrice daily, according to age, with undoubted benefit. If the gums are inflamed and swollen I divide them freely down to the teeth. Some physicians condemn this practice, and even say it is barbarism, but I have not seen the least evil consequences from this little operation. On the other hand it has always been followed with unequivocal benefit in my hands. In cases attended with cerebral irritation this operation should never be neglected in my opinion. I had a striking instance of this kind last summer; was called to see a child who (I was told by the mother), had had diarrhoea for four or five weeks, and had been treated by other physicians with no avail. I found the child very much emaciated, with dry and shriveled skin, tumid and tense abdomen, gums inflamed and swollen, with considerable symptoms of cerebral irritation, and the last-mentioned modification of the evacuations. I took out my lancet and divided the gums freely down to the teeth, gave it a powder of the prescription mentioned. above, with a little morphia added, and to be repeated every four to six hours. Next morning I found the child had rested pretty well all night, a thing it had not done for several weeks. The cerebral symptoms seemed to be entirely removed. I ordered two drops tr. chlorid. of iron, in a little water, three

times daily, the powders to be continued as necessary. A flannel bandage was put around its body, wet with a little turpentine over the stomach and bowels, just enough to irritate the skin a little. The tepid bath was also used. The child made a rapid recovery. In any case attended with periodicity quinine should be administered.

CASE OF COMPLICATED STRICTURE OF THE URETHRA. Reported to the Tri State Medical Association, November, 1885,

BY J. H. NUTHALL, M.D., OF MEMPHIS, TENN.

In the spring of 1878 I was called to see a gentleman who had been under treatment for stricture. His surgeon had used more force in introducing a sound than was prudent, and unfortunately made a false passage. When I saw him there was manifest indication of infiltration of urine; his testicles were swollen as large as an ordinary hat crown, had become sphacelus, and were very offensive. I sliced the scrotum to give it proper drainage, and put him on a sustaining treatment, and when I visited him next morning I found the mortification so great I was very apprehensive of losing the patient. An extensive slough of the scrotum followed, the consequence of which was a large perineal fistula, through which he passed his urine, none passing through the natural channel. It required several months to close this fistula. I continued the use of the sound during the treatment for the fistula. When discharged he was, as I thought, in a very comfortable condi

tion.

About a year afterward I was again called, and found him suffering with retention of urine, and on examination discovered a very close stricture. I was unable to pass anything in the way of a catheter or sound; I succeeded in passing a filiform bougie. I then passed over the filiform, Gouley's dilator, and divulsed the stricture so that I could easily pass a Van Buren sound No. 14, (Amer. scale). This condition yielded so readily to divulsion that I concluded it the result of bands formed in the urethra. I continued the use of the sound for two months, and discharged him with directions to keep up the treatment for a year, introducing the sound at intervals

of from one to two weeks. Now comes the interesting history of this case. Last April he applied to me for the relief of pain that came on every morning and afternoon. These pains would come on at regular periods—at 11 A.M. and 3 P.M. His statement was that they commenced about six months before he applied to me; at first they were of short duration, and the pain insignificant; they gradually grew worse and stayed with him longer, until they had become excruciating and made him sick all over. A remarkable feature was the periodicity, and a desire to urinate just at these particular times, the pain always following urination. They would commence in the groin, and would seemingly go all over him. Upon examination I found him again with a very close stricture, the result of not keeping up the use of the sound. I divulsed the stricture with Gouley's dilator, but it being of cicatricial tissue it would jump back like a piece of rubber. I now concluded that this pain was reflected, and was caused by a nerve fibre being caught in the cicatricial tissue, and the contracting of the stricture produced the pain. The stricture was in the membranous portion of the urethra. I divided it with the urethrotome so that I could easily introduce a No. 16 sound, (Amer. scale). The operation was entirely successful. It has now been about eight months since I operated, and the patient has not had the slightest pain or inconvevience from the stricture since.

In connection with this operation I will speak of the local anæsthetic-cocaine. This man's urethra was so sensitive in the last operation that he could not bear for me to introduce anything whatever in the way of a sound. This sensitiveness extended the entire track of the canal. I concluded 1 would try cocaine before resorting to ether for the examination. I introduced ten minims of a four per cent. solution with Bromstead's long-nozzle urethral syringe. The anaesthesia was so perfect it enabled me to introduce different sizes of steel sounds down to the stricture, and I used all the force justifiable without giving the patient the slightest pain. Dr. A. M. West, formerly of Holly Springs, Miss., but now of Memphis, kindly assisted me in the operation.

CASES ILLUSTRATING THE EFFECTS OF ELECTRICITY IN AMENORRHOEA AND DYSMENORRHOEA.

Read before the Shelby County Medical Society,

BY G. W. OVERALL, M.D., MEMPHIS, TENN.

In order to avoid tautology in reporting cases treated in a similar way, I will give in the outset the general modes by which I am governed in the application of the different cur

rents.

It is very important, in order to procure the therapeutic effect of the currents, to have good batteries and keep them in good working order. I use in office a combined table battery (Fig. 1), which is very complete and convenient in its

arrangement. It is operated by thirty-six gravity cells, has galvanometer, rheotome, commutator and rheostat. The latter has current selector, by means of which from one to twentyfive hundred ohms' resistance can be brought into either the galvanic or faradie circuit.

For general faradization or central galvanization I use a cabinet (Fig. 2). The electrodes are so arranged in it that a current can be directed through any part of the body.

Fig. 2.

It also admits of the administration of medicated or simple vapor baths, which are valuable adjuncts to treatment in many cases.

Case I. Unmarried; applied for treatment April, 1884, suffering with amenorrhoea. She was twenty-one years old, very delicate and anæmic. She said she had had her sickness but two or three times, when it was induced by the use of strong medicines, and was attended with great pain. She had taken all kinds of tonics, including iron, cod liver oil, etc., without the least benefit. She suffered intensely with her back, and the pains at times extended down her limbs. I began giving her the electric vapor baths in the cabinet. I used the primary faradic current, directing it from the seat and back to the pubic and right and left hypochondriac regions. The current therefore passed directly through the uterus and ovaries. One pole was passed for a few minutes up and down the spine. The applications were made daily in the above way for two weeks, when her menses appeared and without the least pain. The flow, however, was very scant, and only lasted one day. I waited three days, then began the treatment in the same way as before. She continued the treatment regularly for twentyfive days, when her catamenia reappeared. It was perfectly