vix acts as a sort of sphincter in opposition to the other uterine muscles and the barrier it produces can be overcome in three ways: By stimulating the uterine contractions, by the introduction of foreign bodies, etc.; (2) by overcoming the sphincter action by manual or instrumental means, and (3), by incision. Previous to the introduction of the Bossi dilator Edgar incised cervices, but since then has done this in very few cases. His experiences teaches him that after the thirtieth week mechanical methods will suffice in most cases and bimanual stretching of the cervix has given the best results. It is a closer imitation of the natural process than any other. It allows greater force. There is less danger of rupture of the membranes or of laceration. It does not interfere with the original presentation. It is less fatiguing. In placenta prævia there is less separation of the placenta, and last and most important in his opinion, it can be performed while a part of the fetus already occupies the vagina. When much resistance is encountered from a non-disappearance of the supravaginal portion of the cervix and time does not permit the use of hydrostatic bags, he finds the Bossi dilator invaluable. Ten or fifteen minutes use of this in such cases sets up uterine action, softens the cervical rings and permits a subsequent safe manual dilation. He never uses it to complete the dilatation, as he considers it unsafe for that purpose. For slow cervical dilatation his main reliance is on the hydrostatic bag of the Champetier de Ribes type.

INJURIES TO THE CHILD'S HEAD DURING LABOR.

The injuries of the child's head during labor form the subject of an article by B. Sachs, New York (Journal A. M. A., November 10). In his studies of infantile cerebral paralysis, his attention was directed to the fact that a very considerable number of the infants were either first-born children or had been born after prolonged, often dry, labor, which careful statistics of several hundred such cases showed is more harmful than well-managed instrumental delivery. In first-born children and in protracted labor there is apt to be serious compression of the skull and brain

and consequent hemorrhages from the minute vessels, especially of the pia, with resulting effusion of blood over more or less of the surface of the hemispheres. He is firmly convinced that protracted labor is the most powerful factor in the production of infantile paralysis, imbecility, and particularly epilepsy in these cases. He therefore warns obstetricians that, other things being equal, and, above all, the life of the mother not being in danger, it is wise to curtail the length of labor as much as possible, and not to wait till the action of the child's heart becomes feeble. By their doing so he thinks many children will escape epilepsy, idiocy and paralysis. Medical men have heretofore not sufficiently considered the child's future welfare in their management of confinements.

GONORRHEA IN WOMEN.

For the vulvovaginitis due to Neisser's coccus, Archambault recommends injection twice a day of a quart of 1 to 2000 to I to 4000 potassium permanganate, followed by mercury bichloride I to 2000, and a dressing of 5 per cent. ichthyol in glycerin. Resorcin, in doses of 15 grains, he thinks may be given internally with advantage. Twice a week, silver nitrate solution should be used to swab the inflamed mucous membrane, and following this, a powder of alum, 3 parts; tannin, 2 parts, should be insufflated. Frequent bathing and other hygienic means should be employed. If there is complicating cervicitis and metritis, dressings of ichthyol, 200 parts should be used. Local applications of tincture of iodine or of zinc chloride, I to 50, may be employed, and intrauterine injections of about 1 1-2 ounces of the following solution: alumnol, 2 1-2 parts, tincture of iodine and alcohol, each 25 parts. Intrauterine bougies are useful, as, for example, tampons of beeryeast, which act by liberation of lactic acid. Urethritis should be treated by the balsams, the alkalies and by irrigations of silver nitrate or protargol solutions, or a one per cent. aqueous solution of thallin sulphate.—Ex.

an forng, formerly of Cincinnati, then of Chiberat dễ boa Vi spines, has returned to Chicago and has igranted pathologist to Michael Reese Hospital.

Afriname, of fireslan, has been granted 100,000 marks

by the German Government for the prosecution of his experiments as to the etiology of syphilis, which he has been conducting at his own expense in Batavia.

Gaillard's Southern Medicine, Dr. Wm. E. Fitch owner and editor, has removed to New York City, and in the future the journal will be issued from New York, where its founder so long edited it.

Dilatory Druggists.—The writer recently prescribed in a suburb of Cincinnati, cataplasma kaolini, and they were unable to get it filled at any of the drug stores in that vicinity, the druggists not knowing what it was. They then took it down town to one of the leading stores and this druggist had to call me up and ask what it was. The same thing happened with thymolis iodidum. Our druggists should spend less on the soda fountains and get and read the last edition of the pharmacopeia. It has been out over a year.

The Mental Symptoms of Neurasthenia.-Hunt (Medical Record), says that, since Beard's definition of this disease as a neurosis, views as to its nature have somewhat changed and the tendency now is to lay more stress on its mental aspect and to classify it among the psychic disorders. This, while being a step in the right direction, is somewhat too radical, and he believes that neurasthenia is better regarded as neuropsychosis. One may have a patient who is almost normal, and another who is almost insane, and between these two limits are found the neurasthenias. The mental symptoms are these: (1) Mental irritability; (2) weakened attention; (3) depression, deep pessimism; (4) introspection; (5) slow cerebration; (6) loss of memory; (7) obsessions; imperative ideas and impulses; (8) the phobias, morbid and anxious; (9) temptation to do wrong; (10) impaired judgment; (11) nagging and faultfinding; (12) excited emotional outbreaks. These symptoms are taken up one by one and their chief characteristics described.

Items of Interest

BY E. S. MCKEE, CINCINNATI.

Doctors in Japan number 35,685, and the New York Sun facetiously remarks that the population continues to increase. The burning question is, how did they ever get so many doctors in so short a time, and what will happen unless this marvelous production is stopped?

The Giving of Drugs.—Shattuck (Boston Medical and Surgical Journal), gives these rules: To do no harm; to have a clear idea whether we give the drug as a specific, a curative, a palliative or a placebo; to give the drug uncombined, if possible, though to this rule there are many exceptions. When using an efficient drug one should be sure that the preparation is efficient, and should continue its use either until the desired effect or toxic manifestations are produced.

Gullible Answerers of Advertisements.-Van Elk, the member from Holland of the International Anti-Quackery Association, relates a true story of an advertisement appearing in the papers stating, that for 75 cents a powder would be sent, which, if scattered on the waters of a stream or pond, would stock it with edible fish. Answers containing the required amount were received, but the money was returned with the statement that the advertisement was inserted on a wager that no paper would accept such a nonsensical advertisement, and that if inserted no one would be found so foolish as to respond to it, if published. There were two hundred and fifty-seven replies.

Dr. Maximillian Hertzog, formerly of Cincinnati, then of Chicago, later of the Philippines, has returned to Chicago and has been appointed pathologist to Michael Reese Hospital.

Prof. A. Neisser, of Breslau, has been granted 100,000 marks