421 scarcely a one convicted. They are, however, not the only ones ap pealed to. A writer in the Medico-Legal Journal says: "Every man who undertakes the practice of medicine is met upon the threshold of his career by one of the most powerful, baneful, damning combinations of temptation that can possibly assail the human heart. All that is good, all that is evil within him, is subjected to the utmost pressure that can be brought to bear by the combined influences of pity, sympathy, and sometimes greed. Youth and beauty on bended knee, with clasped hands and streaming eyes, implores him with more devoted earnestness of purpose, with more burning reality of feeling than that with which it approaches the throne of grace."

This is, indeed, a stirring and saddening experience. No self-respect ing man, with the courage to do his simple duty and the rectitude to decline to do murder, can dare to swerve from what he knows to be right. "I will give no deadly medicine to any one if asked, nor suggest any such course, nor will I conspire with a woman to destroy her unborn child." declares our Hippocratic oath. But I conceive we can be of immense assistance to the poor unfortunates who thus apply to us. We can save many half-crazed young women from taking this desperate step by a vigorous recital of its perils, and an appeal to her love of self-protection to find some other way out of the dilemma. One end of the horn may be the muzzle of a shotgun and the other lying-in retreat. We can peremptorily dissuade a misguided married woman who prays for relief of her burden, because she cannot afford another child, by asking her why she does not implore us to kill one of her other children instead of the innocent babe in the womb, and by telling her the crime is equally as great and would be much safer for her own life and health.

This subject has always been one of vast solicitude to the profession. When the American Medical Association met in this city in 1857, a strong committee was appointed to report upon criminal abortion with a view to its general suppression. Later the association published a prize essay by H. R. Storer, of Boston, entitled "Why Not? or a Book for Every Woman," in which the wickedness of the crime was set forth and condemned, and its harmful effect and dangers explained. This did great good, but we need another Moses to lead us out of the wilderness of crime.

The cause of humanity is somewhat protected by the fact that any man who will commit an abortion cannot, as a rule, do it with safety. Out of 116 cases of criminal abortion, collected by Tardieu in Paris, 60 died outright and many had a lingering convalescence If there were no other functious for a Bureau of Public Health in this country than the stamping out of the criminal abortionist, the increased population and future prosperity of the United States would amply justify its

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creation. We have a Bureau of Animal Industry for the prevention of diseases among cattle and the detection of trichinosis in pork, yet there is not a law that is operative in the prevention of the wanton and wholesale slaughter of these human beings. Our nation has just concluded a relentless war at an enormos expenditure of money and the cost of many valuable lives to avenge the murder of 256 sailors. The tremendous daily output of abortion-mongers outnumber many times over the unfortunate victims in the Maine disaster, and yet there is not a voice of official protestation raised at this unholy warfare.

ACETANILID AS A PREVENTIVE OF PREMATURE EXPULSION OF THE OVUM.-Harnsberger (Journal of the American Medical Association, Oct. 22, 1898) believes that interrupted pregnancy is not, as a rule, due to single causes, but is the result of a combination of several, the underlying condition being a systemic or nervous depreciation brought on by the early operation of over-strained or other sinister influences incident to modern times and modern modes of living. By directing proper attention to the predisposing first cause, the tendency to abortions and premature labors can be notably limited. With women in whom the existence of pregnancy is uncertain but strongly suggestive during the first two months, it is desirable that the uterus should be assisted in retaining the products of conception if present. We frequently see women who are usually regular pass over a catamenial period. Their suspicions may be aroused, but at the appearance very soon thereafter of the menstrual flux, though it should be accompanied by an increased discharge and more pain, it is looked upon as only a delayed period, they being unaware that one of the clots which has been expelled contained the immature ovum. In such instances, as well as in habitual abortion, the author advocates the exhibition of five to eight grains of acetanilid, repeated in one, two or four hours as necessary. In cases of ovarian irritation, where there seems to be a tendency to separation of the ovnm at what would have been a menstrual period, the more or less regular use of viburnum prunifolium and potassium bromide, with acetanilid at the time of each periodic disturbance, is recommended. In emergency cases acetanilid 10 to 15 grains, repeated at short intervals, should be given. For those who are not accustomed to this drug it would be well to begin with 5 to 71⁄2 grains, but in every instance individual susceptibility should be considered.

Harnsberger has employed acetanilid in the manner indicated for several years, and has never seen alarming or even objectionable symptoms arise-such as nausea, vomiting, collapse, or cardiac depression-ɔr cumulative action following its use. It does infrequently give rise to a rather profuse perspiration, but this in no way interferes with the successful progress of the case. Contrary to the observations of Dulacska and others, he finds that the action of the drug on the vascular system does not tend to induce dangerous hemorrhage.-Med. Age.

IN CHARGE OF

J. W. P. SMITHWICK, M. D., LAGRANGE, N. C.

INFANTILE HYSTERIA. (Ferrin Arcb. de Neurologie.) Eighteen cases are reported in children from one to fourteen years of age, eight being under four years. Boys and girls were affected with equal frequency. The hysteria of infants is as frequent as the hysteria of adults, and it is of the same varieties, simulating disease of the medulla, of the cerebrum, or of any other viscus. Among the reported cases five gave the clinical picture of meningitis; four showed organic paralyses and contractures, one had toxic paralysis, two had polyuria and polydipsia as in true diabetes, and one simulated coxalgia. In addition, hysteria may be associated with other neuroses and organic diseases, making the diagnosis more difficult. Thus a rythmic chorea accompanied an atrophic infantile hemiplegia in one case, and in another hysteria coexisted with presistent mental degeneration; Pott's disease and hysteria also occurred in the one patient. The diagnosis is always difficult in children, and must be made with the greatest reserve and care in the light of family history and the symptoms. The prognosis is usually accounted good, and the symptoms are certainly less tenacious of correction than in adult life, but they recur with remarkable facility in the same or different forms. Consequently the future of any child with marked hysteria must be very gravely considered. As etiological factors we have to consider the predisposing causes of a neurotic or alcoholic heredity, and the exciting causes of trauma and strong emotions-fanatical, religion, superstition, fear, etc.

In regard to treatment, prophylaxis must consist in the avoidance of over-stimulation, both emotional and intellectual, in children who have an hysterical predisposition. As for the disease itself, drugs are absolutely valueless, except iron, in anæmic cases. It is by appealing to the child's intelligence to understand and carry out an order, and by convincing him that he is going to get well, that the greatest success is obtained. As for the use of hypnotism, valuable as it is in the hysteria of adults, it must be used with extreme care, if at all, in these susceptible children, and in early infancy can hardly be of use at all.Archives of Pediatrics.

H. T. BAHNSON, M. D.,

IN CHARGE OF

R. L. GIBBON, M. D.,

J. HOWELL WAY, M. D.

OPERATION FOR REMOVAL OF ENCY STED GALL STONES OF LIVER. CONDITION ACCOMPANIED BY TOTAL OBLITERATION OF GALL BLADDER.-(Dr. F. F. Knorp, Pacific Med. Jour.) The history of this case is as follows:-Mrs. C. L., age 32 years, married, native of Prince Edward's Island, Canada. Patient was perfectly well up to five years ago, when she first was attacked with severe pain in right hypochondriac region accompanied by vomiting, and lasting one hour, after which she was well as ever for a year when she was attacked in same way, this time soreness following the pain and lasting a week. Attack was repeated in another year, this time coming on one month after confinement. This was followed by a similar attack in another year's time. Last June she had another attack but this one was accompanied by jaundice which lasted five weeks, and then entirely disappeared but only for twelve days when both pain and jaundice again returned. At this stage the patient came under my observation, and was suffering with excruciating pain in right hypochondriac region, jaundice, vomiting, temperature 105 deg. clay colored stools, etc. The stools were carefully strained but no stone found. The liver was found slightly enlarged, tender on pressure, and opposite the tenth costal cartilage at margin of right rectus a hard lump the size of a walnut was distinctly palpable, which appeared to be immediately under the skin.

Diagnosis was made of biliary calculi plus extravasated gall, and operation advised. Assisted by Dr. T. E. Bailly I performed the operation on August 31st last and found eight stones encysted in right lobe of liver, at a point corresponding with the vesical fossa. The gall bladder was entirely obliterated, no portion of it being found in the vesical fossa where it should be. The stones were removed, and after carefully searching the common duct and surrounding region for more stones and failing to find any, the cavity left in the liver was stitched to peritoneum, muscular tissue and skin, leaving a perfect drainage.

Recovery was uninterrupted, with the exception of a slight return of pain and jaundice on one occasion and then only lasting for a day. From that time on patient has been free from all symptoms. This case is not reported from an operative standpoint, but for the rarity and peculiarity of the case. My solution is that the stones were originally in the gall bladder, setting up an adhesive inflammation of the anterior bladder wall to liver, a subsequent ulceration and the passage of stones

into parenchyma of liver, the posterior bladder wall now falling against and becoming adherent, acting as one of the liver coverings at this point, the whole process being so completely and neatly done as to erase all trace of the gall bladder.

Therapeutic bints.

HOW TO APPLY PLASTER OF PARIS.-Dr. Lester Keller, (Med. Council) says the greatest objections are that it will not set quick, and that it will crumble. Let us prepare bandages. We want some cheese cloth, fresh plaster, a pepper-box with large perforations, full of pulverized alum, and a smooth board about 10 inches wide and 3 feet long. Tear your cloth three times as wide as you want your bandages and from 4 feet to 9 feet long. Spread it out on the board, and as the assistant pours on the dry plaster rub it in well with the hands so as to fill up the meshes of the cloth. Have a little alum dusted on, fold the cloth on itself, so as to make three thicknesses, roll up very losely. Treat the entire roll that way, and remember a little excess of plaster is a very good thing. When we are ready to put on the dressing we want plenty of rolls so prepared, two bowls of warm water, a piece of oil cloth to put under the dish, a large sugar shaker full of dry plaster, a big apron, and an assistant.

Put one of the rolls in the water, and after it has become wet through, give it a gentle squeeze and apply it to the limb. After it is on, dust on some dry plaster from the sugar-shaker, dip your hands in the water and rub them over the outside of the bandage. Apply rolls as long as necessary to get the bandage heavy enough, and then give it a good coat of plaster on the outside. Your assistant will keep busy keeping the bandage wet (only one should be wet at a time), dusting on the plaster, and occasionally giving a dash of alum. Keep your hands wet rubbing them over the surface of the dressing. Make your strips of cloth short so that the inside of the roll will not set before you get it all on. Work your plaster wet and it will not crumble. Put in the alum to make it set quickly. Above all, WORK-quickly.