however, that in cases of capillary hemorrhage, as for instance in epistaxis, ergot is of great service locally and is also indicated internally. Dr. H. A. Hare said that the remedy is distinctly indicated in case of capillary hemorrhage, but that it can do no good in hemorrhage from a larger vessel. Dr. Packard spoke of the difficulty of distinguishing between arterial and capillary hemorrhage unless the bleeding point could be inspected.Philadelphia Medical Journal.

FEMALE DISEASES AND INSANITY. It is perhaps the inherent vanity in the race that keeps it alive. Were every man to look at himself with the strictly impartial view of his neighbor, his self-appreciation would ooze out, his upwelling ideas would leak away, and his ambitions would sink to the low levels of other men's esteem.

Ah, no! it would not do to stand on the street corners and smite our breasts as miserable sinners. It is far better to congregate in high places, in clubs, in medical societies, and in the editorial corners of our journals, and unite our voices in thanks that we are not as other men are. Then our fellow-citizens may see how wise are the tenets of our specialty and how false are other men's.

Who but the greedy, grabbing gynecologist would insist that it is disease of the ovaries or false position of the uterus that causes the trouble, when it is plain that the nerves are the seat of the disorder? And why should not the triumphant neurologists congregate and rejoice when they see the value of their claims recognized and the fees running in their direction? Witness the recent appreciative abtract of the Italian observers, Angelucci and Pieraccini, in their international inquiry on the relationships of diseases of women and nervous disorders.

One of the most pronounced articles illustrating the general point in question, and one which should receive the attention of both neurologists and gynecologists, has recently appeared in the American Journal of Insanity, vol. lv., 1898, No. 1, July, entitled "Surgery Among the Insane in Canada,” by R. M. Bucke, M. D., President of the Medico-Psychological Association.

He has been led to believe that there is a great deal of pelvic disease in female lunatics, and that such disease has often a causative relation to the mental alienation existing. His investigations in the London (Canada) Asylum, the examinations being made by a competent gynecologist of that city, show that of 132 patients there was organic disease of the generative organs in 122, only 10 being free. Of the 122 cases of organic disease, 109 had been operated upon. In the report of the pathological conditions operated upon, many minor troubles were mentioned. His tables included: menorrhagia, 14; endometritis of various grades, 62; hypertrophied cervices, 25; lacerated cervices, 34; cystic cervices, 19; polypi of the cervix, 3; fibroids, 7; epithelioma and sarcoma, each 1; retroversions, 33; procidentia, 5; ovarian tumors, 8; perineal injuries, 22; and fistulæ, 2.

The results in the 109 cases were:

(1) As regards bodily condition. Three died from the operations and all of the rest were improved.

(2) With reference to the mental condition. In 39 cases the patients recovered from their insanities, in 32 cases there was marked improvement, and in 35 there were no changes for the better. The author's conclusions, in view of the almost chimerical results, are worthy of reproduction. "Should it be once conceded by those who have charge of the insane, by those men to whom the general profession looks for guidance in these matters, that utero-ovarian diseases are capable of acting as causes of insanity, and that removal of these will in some cases result in the disappearance of the mental disturbance, almost at once it would happen that many insane women, instead of being sent to an asylum, would be operated upon and relieved at home. More than that, if the connection in question were admitted, these women would not be allowed to remain insane at home for months, and often years, as happens now, but would be examined, operated upon, and relieved within a few weeks of the appearance of the insanity. More even than that, when the eyes of the general profession are fully opened upon this subject, symptoms of subinvolution, endometritis, or laceration of the cervix will be watched for after chidbirth, and if present be at once relieved; and the women who might have become insane in consequence of one or other of these lesions will remain sane."

The Italian compilers above mentioned reported, as the result of an international inquiry, hearing from large numbers of both gynecologists and neurologists, that the relationships in question of pelvic disease and insanity were nil. And here we have this roseate picture!-N. Y. Medical Record.

THE TREATMENT AND COMPLICATIONS OF CHOREA.-1. The frequency with which nervous and other symptoms are met with in chorea places beyond doubt their influence as etiological factors.

2. Hysteria appears to exercise a marked influence on the onset of chorea, so much so that some authors have regarded the latter as a form of it.

3. According to certain writers who have remarked the close connection between chorea and the infectious diseases common to childhood, it would seem possible that the former is but a secondary affection, the sequel of these virulent diseases.

4. On the one hand, the close relation between chorea and rheumatism, so long admitted by clinicians of the highest standing, and, on the other, the bacteriological nature of rheumatism as proved by Achalme, Thiroloix, Triboulet, Coyon and Ladoc, lead me to see in chorea only the cerebro-medullary tendency of a rheumatic infection developed in a hysterical or neurasthenic temperament.

5. Of the numerous remedies to which resort has been made in the treatment of chorea, I give the preference to those derived from the aromatic plants, such as antipyrin (the proper dose of which I have determined), exalgene, asaprol and analgene, whose curative action in the treatment of chorea I was the first to demonstrate.

6. While these remedies have been of undeniable efficacy in the treatment of rheumatism, it is equally true that under their action all choreic manifestations disappear within the space of from eighteen to fifty days.

6. My personal observations have assured me of the successful outcome of this treatment, at least in the case of children whose subsequent history I have been able to follow.-Conclusion of a paper in Pediatrics of October 15, 1898, by Dr. Moncorvo, of Rio Janeiro, Brazil.

TREATMENT OF ECTOPIC GESTATION.-Dr. H. W. Longyear (Annals of Gynaecology and Pediatrics) summarizes as follows: (1) In all cases of intraperitoneal rupture, operate as soon as the diagnosis is made; do not wait for reaction to occur. Support such patients before and during the operation by applications of heat to the extremities and back, transfusions of decinormal saline solution, rectal use of beef tea and saline solution, and strychnine, nitroglycerine, and digitalis by hypoder mic injection. (2) If the hemorrhagic blood cannot be quickly removed, let it alone and use drainage. Do not flush the abdominal cavity to remove blood. The peritoneum will absorb the blood with much less danger than is caused by such manipulation. (3) Use silkworm gut en masse to close the abdominal wound, in case there has been great loss of blood, as the buried animal suture is not readily absorbed when such depletion has occurred. (4) Extraperitoneal hæmatocele is usually self-limiting and will almost always result in the death of the foetus and the recovery of the patient. (5) In cases that go on to full term, operate at end of pregnancy to save the child. Operate through the abdomen, drain through the vagina, and leave the the placenta to come away through disintegration. (6) Electricity should be used only in cases so situated as to preclude the possibility of securing proper surgical treatment.

ENLARGED CERVICAL GLANDS.-When a patient comes to you with enlarged lymph nodes of the neck, be sure to examine the throat most carefully. If the patient is a child, remember that a very common cause of lymph-node inflammation is the presence of hypertrophied tonsils or of adenoid vegetations. In an individual of middle age, examine any hypertrophy criti cally, bearing in mind the possibility of neoplasm.-International Journal of Surgery.

SANDER & SONS' Eucalyptol Extract (Eucalyptol).-Apply to Dr. Sander, Belle Plaine, Iowa, for gratis supplied sample of Eucalyptol and reports of cures effected at the clinics at the Universities of Bonn and Griefswald. Meyer Bros.' Drug Co., St. Louis and Kansas City, Mo., Dallas, Tex., and New York, sole agents.

TAXIS AND MODE OF INCISION IN STRANGULATED FEMORAL HERNIA. In strangulated femoral hernia the directions laid down by the older authors as to the mode of applying taxis counts for positively nothing; nay, they are worse than useless, for their employment implies that manipulation is reasonably safe and certain, while experience disproves both; and more, by this unsurgical procedure the intestine is often irretrievably damaged beyond repair by the crushing and tearing of the fingers.

In former times the rules for incising or dividing the seat of strangulation were laid down with great fulness, and a special probe-pointed bistoury was devised for the blind moping in the dark. The operator always had a terrible dread of hemorrhage.

My own experience with this and all other types of strangulation emphatically induces me to advise the rejection of protracted taxis, baths and antispasmodics. The use of pulmonary anæsthetics in taxis should be strictly proscribed. Let us always cut from the outside in, and then if we divide one or more small vessels, close them, as we would in any other operation. But let us invariably open the sac, freely divide all constriction, draw down and thoroughly free the intestine before we reduce it. -T. H. Manley, M.D., in Med. Times and Register.

CHILBLAINS.-C. Binz (Cincinnati Lancet-Clinic) thinks that only chemicals capable of penetrating the epidermis can be expected to have any effect upon chilblains. To these belong chlorine in the form of chlorinated lime. He has found that one part of this, mixed with nine parts of paraffin ointment, rubbed into the inflamed parts for five minutes every night, will cause the pain and swelling to disappear in the course of a week. After each inunction the foot is covered with a very thick bandage. It is important that the ointment should have a very strong odor of chlorine, and he points out that the chlorinated lime of shops has generally parted with its free chlorine. Another point of importance is that the drug should be mixed only with paraffin ointment, for Binz has found that when mixed with lard, and especially with lanolin, it gives up its chlorine too quickly. The ointment is useful only so long as it gives out a decided smell of chlorine.-Maryland Med. Journal,