or other disease to explain the fever, her temperature and pulse suddenly dropped to about normal, and she made a fairly good convalescence. Her milk came the night following the day that her fever left her. Her friends told me that she had a similar complication when her other child was born, which had frightened the attending physician the same as it did me.

Three weeks after the birth of this child I saw the mother again in another of her "fits," and found her temperature 104° F., pulse 120. No lung trouble or disease in any organ, that I could find. This lasted two days, and suddenly dropped to normal.

Six weeks from this time I was again called to see her, and again found a temperature above 104° F. and a pulse correspondingly high. All the indication of disease I could find at this time was a moderate diarrhea. The next day her temperature and pulse were nearly normal, and her diarrhea better. Since this time I have treated her for pneumonia, during which her temperature was only moderately elevated.

Here, then, are five observations in the same patient of high temperature with nothing to explain it. It might be urged that in each instance there was some positive disease present which I failed to detect; as, some may claim after her confinement the fever was due to puerperal infection, and in the last observation to diarrhea. A temperature of 105° F. following childbirth is suspicious of puerperal infection, but can we base a diagnosis of infection on the fever alone? In this instance I was uneasy about my patient and called in consultation another physician, and he failed to find anything to suggest infection except the fever and pulse. Ten hours after parturition is early for infection to give rise to a temperature of 105° F., while we must admit that the excitement of childbirth would be a potent factor in producing hysteria.

In an article "On the Use

THE INTERNAL USE OF CHLOROFORM. of Chloroform as an Internal Remedy." A. P. Merrill, M. D., of Memphis, in The American Journal of the Medical Sciences, October, 1865, advised its administration in large (teaspoonful and even greater) doses and undiluted, in many cases of disease, especially "in every kind of convulsive movement," and in the "chill stage of all fever, in its most fatal and epidemic form." Let me quote a few passages from this paper: "Objection is sometimes made to the introduction of unmixed chloroform into the stomach, on account of its highly excitant quality. But experience proves it to be much less stimulating to the mucous mem

brane than to the skin, and in no case have I observed anything more than very temporary effects upon the mouth and throat, which soon subside. The vehicles we are advised to employ in its administration can only hold the remedy in temporary suspension, and in most of the cases requiring large doses it is quite impossible for the patient to swallow them. Sometimes a single drop into the folds of the neck will cause vesication, while a fluidrachm passing into the stomach gives only a slight inconvenience by its stimulation of the mouth and throat. As in the administration of other remedies, the dose of chloroform must be varied with the nature of the case, and more than with most other remedies given. I have administered it in doses of a single drop to two fluidrachms, and I have sometimes repeated it in short intervals; and I have reason to believe that the cases of infantile convulsions, in which I have given from one-half to a full drachm, might have been relieved in the inception of the disease by fifteen or twenty drops. But when convulsions have continued for an hour or more, the smaller doses will have no perceptible effect. Indeed, relief in such cases is obtained only by such quantity as will produce sleep. The sleep continues from one to four hours, and is sometimes followed by great restlessness and jactitation for an hour or more, when the patient is at ease again and sleep returns. Dr. Merrill gives particulars of fourteen cases in which a teaspoonful of undiluted chloroform was successfully administered, and in some of them the dose was repeated in half an hour. The ages reported in these cases vary from a child of a year and a half to "an elderly lady, very fat and plethoric." Of these fourteen cases, five had convulsions, three had chills, two were poisoning by strychnine, and one each of asthma, sunstroke, epilepsy, and fit of cramp colic. I will relate Case VI, as a "specimen brick." "A child, aged about two years, was taken with a convulsion while riding in a little hand-carriage, supposed effect of a chill, although the child had not had chills previously. When I arrived her mother and others thought the fit had continued two hours. She had been several times in a hot bath. Sinapisms had been extensively applied and a physician was administering chloroform by inhalation without effect. The pulse was hardly perceptible, the eyes open and bloodshot, pupils dilated, skin of a purple color, jaws clinched, fingers and toes tightly drawn inward, and the whole frame severely convulsed. I administered a teaspoonful of chloroform by the mouth, the physician present admonishing me of the probable violence to the mucous membrane and of her inability to swallow, and a few minutes afterward as

much more was given by enema. Very soon she was quite relieved of all spasmodic action, and in a sound sleep. A dose of calomel at night, and quinine for several successive mornings, completed the cure." Since the publication of Dr. Merrill's article I have often prescribed chloroform in similar doses, and never with any unpleasant result, but have uniformly found it very serviceable in proper cases. For the distressing pain of congestive dysmenorrhea I considered it a specific. It will give prompt relief from the awful agony of bilious colic, and in epileptic and infantile convulsions, it "acts like a charm." A teaspoonful of undiluted chloroform, followed by no drink of any kind, is a hot dose; but the pungent effect is but momentary.-T. C. Wallace, M. D., in Med. Record.

CONSANGUINEOUS MARRIAGES.-There is a widespread belief that the marriage of persons nearly related by blood is likely to result in offspring of imperfect physical or mental development. This, most medical men know to be true-not for the reason to which the result is usually attributed by the laity, but because consanguineous marriages concentrate in the offspring the physical or mental defects or weakness of the parents, as both parents are likely to have the same sort of defects or weakness, while in other marriages the risk of a coincidence of the kind is comparatively slight. But, real as is the danger in consanguineous marriages, the mere fact of consanguinity is not in itself a danger to the offspring. There are many proofs of this in history, while an interesting addition to them may be found in a recently published book by His Majesty Kalakaua, King of the Sandwich Islands. This book is entitled The Legends and Myths of Hawaii, and it is edited by Hon. R. M. Daggett, late United States Minister to the Hawaiian Islands. In it the statement is made that "In the royal families, to subserve purposes of State, father and daughter, brother and sister, uncle and niece, frequently united as man and wife. The children of such unions were esteemed of the highest rank, and, strange to say, no mental or physical deterioration seemed to result from these incestuous relations." In commenting on this statement a reviewer in the Nation, September 26, 1889, says: "There seems to be no doubt of the accuracy of the facts here stated. The magnificent physical development, the clear and active minds, and the noble manners of the higher chiefs are matters well within the memory of the present writer and of other former residents of the group."

This contribution to our knowledge of the subject of consanguineous marriages is especially interesting as coming from a country where ad

mixture with a foreign population, and the abandonment of their ancient social customs, has been followed by a deterioration of the native race, which is as pitiable as it is unmistakable.- Med. & Surg. Reporter.

POISONING BY ILLUMINATING GAS.- Dr. W. C. Kloman reports a case (N. Y. Med. Jour.) in which the hypodermic injection of a 1-50 gr. nitro-glycerine tablet brought about prompt and permanent reaction, after an exposure to the escaping gas of seven hours, and when there were no signs of life except shallow and stertorous respiration. "In about two minutes I could feel pulsation at the wrist, and in five minutes her pulse was full and strong. The respiratory movement deepened and her limbs began to grow warm. In about fifteen minutes she became partly conscious, and reaction thoroughly established. I returned to see her in about three hours, when she told me she was all right, except for a slight headache."

SURGERY.

GENITAL IRRITATION IN BOYS.—The personal hygiene of the human infant and that of the puppy present strongly contrasting features, which are not by any means creditable to our superior intelligence. The tongue of the canine mother is constantly engaged in removing from its offspring the excretions adhering to it at birth, or as a result of urination and defecation, and the genitals particularly are objects of grave maternal solicitude. Quite a different plan is followed in the case of the human infant. It is washed certainly, but in the process the genitals receive no more attention from the nurse than the corners of a room from a lazy housemaid. It is then packed in diapers, so that fecal and urinary discharges are preserved in accurate contact with the hitherto neglected genitals, and thus it continues, till lapse of time, fetor or caprice, suggests to the attendant the possible propriety of a change. If to these be added the frightful uncleanliness of mothers in the lower ranks of the working class-although unfortunately this is not peculiar to them-much of the great mortality of childhood, and the moral and physical decrepitude of those surviving that period, may be accounted for in a manner as convincing as it is unsatisfactory.

A momentary comparison of the male and female genitals during infancy, shows that boys labor under greater physical disadvantages than girls, and explains the limitation of the present question to genital irrita

tion in boys. Thus, the genitals of girls are so prominent that their inflexions are within the observation of the nurse, and the meatus urinarius so close to the surface that the contraction of the bladder ejects the urine almost without contact with the surrounding integument. In boys, the glans penis being, as a rule, covered by the prepuce, the meatus urinarius is concealed, and even under the most satisfactory conditions some of the urine is retained in contact with the mucous mem

brane of the glans and prepuce. Under ordinary circumstances, this contact of healthy urine may lead to no great evil, but the inevitable acid dyspepsia of infants with its acid urine, sooner or later exerts its influence, and genital irritation occurs.

The mucous membrane and glands are unnaturally excited, while secretions increase and are pent up by adhesions. Thus, the irritation is not only maintained, but intensified. The boy is in a condition of frequent irritation, and seeks to relieve it by purely physical means, as remote from moral influences as the scratching of the adolescent victim of scabies. He rubs himself, but quickly discovers that tugging at the prepuce is much more effectual. Continued pulling elongates it, its orifice contracts at first spasmodically and later on organically-till finally, in severe cases, the prepuce "balloons out" during micturition, and straining weakens the abdominal wall, and hernia may result.

Case 2 is a striking example of the truth of these remarks. But the fact which I am anxious to emphasize is, that continued irritation of the genitals induces a habit of manipulation which may persist long after the irritation ceases, and which, if retained till puberty, leads to the practice of masturbation in its most odious sense.

A recent controversy in the British Medical Journal has brought this question into unusual prominence, and some of the statements there advanced are very suggestive. There is a squeamishness shown in referring to the subject at all, and an acknowledged difficulty in acquiring accurate information. I cannot help thinking that, if sufficient notice had been taken of the important part played by genital irritation in the development of this habit, both squeamishness and difficulty would have disappeared. It is rather singular that the average professional mind views with satisfaction the extensive literature gathered around the subject of syphilis, and that the acutest intellects in the profession should find an ever-increasing interest in the study of its multifarious manifestations, whilst this subject of masturbation is described as disgusting, and its discussion carefully avoided. He would be deemed a strange physician