In reading this announcement Dr. Boucher observes :

Here

"The microbolent heard three weeks since has given me la grippe. Then I rejoiced. Here, said I, the whole question of paludism and colonial hygiene is settled. Malaria invades all our colonies from Algeria to Maillot. Farewell, internal medicine, petroleum spread broadcast shall take your place. Thank God, our colonists shall no longer perish, and all will be saved who dwell in the tropics. Nevertheless, on second thought, I said to myself, 'What in the devil can one see in this?' even in the Paris academy they propose to sweeten the Parisian swamps, under the direction of the noble Dean of the Faculty of Medicine, the great mosquito exterminator. Destroy the flowers that adorn our parks, too, for it is affirmed that the abominable mosquito, the degenerate wretch, lurks with poisoned fangs in the most beautiful blossoms; it is even claimed that some of these terrors are capable of transmitting chancres to virtuous young persons who frequent garden parties out on the blossom-decked lawns. When such a

and light the way with the tallow dip of modern medical science.

We cannot understand why French science so misconstrues every medical claim for advancement. for advancement. As for ourselves, we

can stand the mosquito. Bitten a million times we survive its attacks. T. C. M.

EDITORIAL NOTES.

THE Board of Medical Examiners for the State of Texas (Regular) will hold its next meeting for the examination of applicants who desire to practice surgery, medicine and midwifery in Texas, and for the transaction of any other business that may come before the board, in Austin, June 15, 1903. For application blanks, rules governing examination, or any other information, address Dr. M. M. Smith, Secretary, Austin, Texas.

THE Ohio State Medical Society will meet in Dayton, June 3 to 5 inclusive. Dr. W. B. Chapman, President.

IN a case of gonorrhea in the male, a chill occurring without swelling of the external organs strongly suggests the possi

enter their homes with the blessed consolation of being able to say, 'Mamma, a mosquito bit me!'"

A certain Colonel Laveran has invented a kind of mitrailleuse to fire upon the mosquito hordes, an ingenious piece of clockwork. The balls fired are in hematozaire skins similia similibus attrabunter.

amine by the rectum, and if the gland is large and tender, and hard though elastic, little time should be wasted before opening the perineum. The old method of opening through the rectum with a trocar is a bad one, because it is unclean and liable to result in the formation of urethro-rectal fistula, and because the abscess cannot be incised and drained as widely as by the

and night.

Surgery.

IT is well to remember that cervical adenitis is often caused by the presence of pediculi of the scalp. It is more frequent in girls than in boys, owing to the greater length of the hair which harbors a larger number of insects, thus causing more irritation and hence more eczema due to scratching. In looking for pediculi they are most easily found in girls in the hair growing lowest on the back of the neck, and in boys in the lank hair back of the ears.-International Journal of Surgery.

Current Literature.

Report of a Grave Case of Tetanus Treated with Veratrum Viride; Recovery. Dr. H. B. Sweetser (Northwestern Lancet) reports the case of a girl of fourteen years who was examined vaginally by a number of physicians for the purpose of determining the nature of an abdominal tumor. Several days later she was operated upon and an ovarian cyst removed. Thirteen days after the operation and nineteen after the vaginal examinations, she developed tetanus. The muscular contractures rapidly became general and there were frequent and severe convulsions. The temperature was moderate, but all the other symptoms were severe.

Antitetanic serum was used, but without effect. Chloral and the bromides also failed. Veratrum viride was then tried, at first in doses of one minim of the tincture hourly (these were without effect), later in doses of four to eight minims of the tincture combined with eight minims of the fluid extract of gelsemium, the combination being given by rectum every hour. This had most remarkable effect in controlling the spasms, but did not affect the contractions. The patient recovered. -Post-Graduate.

General Diseases and Pregnancy.

The relation of various diseases to the pregnant state continues to occupy considerable attention. It seems generally conceded that the condition of the heart muscle is the most important factor in estimating the prognosis of cardiac disease and pregnancy. The majority of patients with heart disease will pass through pregnancy and labor without serious symptoms. Operative interference is dangerous, and if found necessary the uterus must be emptied slowly.

Herman made an interesting study of diabetes and pregnancy, and finds the complication very serious. He advises the induction of labor.

The etiology of acute yellow atrophy of the liver is still obscure, its exact relation to pregnancy is not understood; in spite of our ignorance it has been recommended

Bunions and their Treatment.

The tendency in the treatment of bunions is to do too much or too little, although, perhaps, the latter fault is the prevailing one.

The common site for the beginning of bunion formation is at the bursa on the inner surface of the head of the first metatarsal bone, and a tight shoe is usually responsible for the bursitis which represents the first stage in the development of the deformity. Incidentally the tight shoe is apt to crowd the phalanges of the great toe toward the outer side of the foot, but this, while adding to the deformity, is probably not an essential part of the disease, although it is usually classed as such. With the progressing bursitis three important changes take place:

1. The synovial sheath of the bursa becomes thickened and hypertrophied in its attempt to secrete enough synovia to protect the region.

2. We have the development of a bony protuberance by hyperostosis beneath the

bursa.

3. This change consists in the formation of a thick, horny layer of cuticle similar to an ordinary corn.

Aside from the local pain at the site of the bunion caused by pressure effects on the hypertrophy, we have a secondary cause for inflammation in many cases due to the disinclination of the patient to walk or exercise sufficiently to transform the proteids in his food, and lithemia naturally develops.

If we have a gouty form of uric acid inflammation developing as a result of the lithemia, the patient may suffer from podagra in addition to the results of pressure.

The common forms of palliative treatment, consisting in the use of perforated plasters and removal of the horny layer of cuticle, are not very efficient because of the hypertrophied structure beneath, which will not disappear under anything short of mechanical means.

The older operations aimed at removing the entire head of the first metatarsal bone, and this commonly resulted in a

stiff joint which was in itself a source of much discomfort. If we did not have a sufficiently close union to give a stiff joint, the sharp edge of the metatarsal bone, resulting from exsection, would sometimes cut into the tissues of the sole of the foot, so that it becomes necessary to exsect the heads of all of the metatarsal bones.

As a matter of fact a very simple operation will suffice to give relief in many cases of bunions.

Operation.-A longitudinal incision, not more than half to three-quarters of an inch in length, along the line of the inner surface of the extensor tendons, exposes the site of the hyperostosis, and a sharp chisel separates the button of the bone readily from the head of the metatarsal bone. The open bursa can then be trimmed out with a pair of scissors without difficulty, and when the wound is sutured and the skin pressed against the surface of bone from which the button was removed, it becomes quickly adherent and the bunion is at an end.

This treatment will suffice to give comfort in most cases and no further operative work is necessary, but if the patient wishes to have the phalanges of the great toe placed in normal line with the metatarsal bone it is necessary to divide the external ligament of the metatarso-phalangeal articulation. This can be done subcutaneously, but in doing so we cannot avoid cutting a pretty large branch of the dorsalis pedis artery, as a rule.

Hemorrhage from this cut artery we can usually disregard if a small, round, gauze pad is strapped firmly down upon the dorsum of the foot at this point beneath a light splint. We must inform the patient, however, that sometimes it becomes necessary to enlarge the incision and ligate the artery. I have not been obliged to do this as yet, but have had to exercise a certain amount of skill in making proper application of pressure.

After the simple operation of removing the button of bone, and the thick bursa, very little further treatment is required, and the patient may be allowed to walk in from ten to twelve days.

In cases, however, in which it has been thought desirable to correct the hallux valgus by division of the external lateral ligament, we must apply a splint to be worn inside the shoe, which will hold the

phalanges in place for several months. A very good splint is made by hammering. a piece of sheet copper into the shape of the sole of the foot, and turning up a flange which corresponds to the external surface of the great toe. A special stocking is then made with a separate compartment for the great toe, so that the flange from the splint can be interposed between the great toe and the next one.

Very few patients are more grateful than the ones upon whom we operate for the cure of bunions, and it does not seem to be generally known by the laity that we can remove this deformity.

Not long ago, while in a country store, one of the old inhabitants who occupied a cracker box, said to me-without knowing that I was a physician-that no one could cure bunions, and remarked very impressively that he would give $100 to any one who could cure his. I told him that the usual price for curing them was about twice what he offered, but that it could be done very easily and for nothing at all, if he was not able to pay what the services were commonly considered to be worth.ROBERT T. MORRIS. M.D., in International Journal of Surgery.

Alcohol and Insanity.

The fact that a very large proportion of the persons who find their way into our lunatic asylums have been addicted to the abuse of alcoholic beverages is not of itself conclusive proof that alcoholism is an etiological factor of overweening importance in determining the loss of mental equilibrium. The more closely we study the personal and family history of the chronic inebriate the more apparent does it become that the habit is the consequence, rather than the cause, of the mental weakness, a view which has not been without influence in recent legislation. This displacement of the popular relationship of cause and effect is even more marked when the history of the alcoholic insane is inquired into. A very large proportion of the victims come of a neurotic stock, many of them live, so to speak, in an atmosphere of physiological misery, and life is more or less a burden to them; hence the willingness with which they fly to alcohol.

For a brief period the stimulating action of the alcohol restores the balance of the