He recalled the

terrible accidents, and even death follow it. melancholy case of Jailly, a law student, who died in consequence of the inoculations performed on his person.

Dr. Auzias responded that Jailly died, not from syphilisation, but from erysipelas. To which Dr. Ricord, boiling with indignation, replied: "I solemnly affirm (je le jure) that I saw Jailly before his death, and that he died from the results of inoculation.

Here a perfect tempest of feeling and noise arose which President Bouilloud found it almost impossible to allay. At last silence being restored, Dr. Hinton fortified Dr. Ricord by the history of a case of syphilisation which proceeded rapidly to a fatal termination; and the violent discussion having at length been brought to a close, a commission was nominated, at the suggestion of Prof. Behier, and the meeting separated at a very late hour. So the last of syphilisation is not yet. It dies hard. Possibly the report of this commission may prove its extinguisher. L. P. Y., JR...

Health of New Orleans.

[Owing to our illness we are behind in our issue, which enables us to insert the following extracts, which are of so much interest to our readers: ]

From the New Orleans Medical and Surgical Journal.

The absorbing topic of professional interest, throughout the South-west, during the present season, is the epidemic of Yellow Fever, and we should not do justice to our patrons in this portion of the country, nor to more distant readers, to ignore it at this time. The malady is still prevailing, and it is of course impossible now to take a complete view of its progress; this must be reserved for a future issue. For the present we shall speak only of its most striking characteristics, and of its progress since the publication of the last number.

Each manifestation of an epidemic disease presents individual traits, to distinguish it from others of the same malady; and the yellow fever of 1867 will be long remembered for its well marked

peculiarities. We have before spoken of the early appearance of sporadic cases, and its late establishment in an epidemic form. The mildness of the type generally prevalent here was alluded to, as well as its inclusion of negroes among its subjects. To a confirmation of these traits it may now be added that this epidemic of the fever is the most sweeping one ever known in the history of our city. No class of the population can this year claim or expect exemption from its ravages. It was generally supposed that natives of the city enjoyed an immunity, and that those born and raised in the vicinity possessed it in proportion to their contiguity. It was also believed that one attack was a fair guarantee against all future danger from the fever. This year it has violated all these precedents most incontestibly, and in numerous instances. Infants at the breast have appeared to be almost as susceptible to the infection as any other people, though most have experienced very light attacks; but bad cases have not been wanting, and, in the writer's practice lately, occurred a case of black vomit in an infant only one month old.

Secondary attacks, formerly considered rare exceptions, have this year been found numerous and well attested. Even some who were known to have the fever in 1853, have again had well marked attacks. It is to be remarked, however, that these secondary cases have been, almost without exception, tractable ones, and have terminated favorably. The absence of large numbers from the city during the war is supposed to have cost them the immunity previously acquired, and rendered them measurably susceptible again to the infection.

We are not aware that any new light has been thrown upon the vexed questions of contagion and portability, nor that its introduction from abroad has been established with any degree of credibility. The quarantine has been maintained throughout the epidemic, at the mouth of the river, and it is certain that, under the present system, it has proved inoperative to debar the disease. Whether any different system would be more efficacious is yet problematical, and it does not seem probable that the question will soon be decided.

The

The following table, based on official returns to the Board of Health and the municipal authorities, and borrowed from the Crescent newspaper, exhibits the daily mortality for September and October and meteorological observations for October. mortality reports are compiled from the sexton's returns of interments at the several cemeteries, and include some individuals who died in the suburbs, but not those in the military service. These exceptions, however, do not materially affect the result.

It is to be observed that the figures for each day give the number of interments for the twenty-four hours ending at 6, A. M., of the same date:

As in former epidemics, the HowARD ASSOCIATION have been active in their mission, to relieve the wants of the sick and destitute, and the gratitude of this impoverised community is due those Northern friends who have, with free hand and open purse, promoted the efforts of our self-sacrificing citizens. The Medical profession have freely responded to all demands for their services, and the means at the disposal of the Association have enabled them to supply medicines and subsistence wherever they were required. The writer can testify, from personal observation, to the immeasurable benefits of these well-directed efforts.

At this date (1st, Nov.) and while the days of the present visitation of yellow fever can almost be numbered, another not less dreadful destroyer seems desirous to renew its ravages. Last year the cholera was predominant-for a short time almst epidemic-while the fever modestly stood in the background; but its blows, though few, were severely felt. This year the cholera

early presented a threatening aspect, but had the courtesy, in its turn, to yield precedence to its old rival, and for weeks was scarcely heard or thought of. Now that the fever is about ready to withdraw from our midst, whether from want of subjects or before the advance of its invincible frosty foe, the cholera has quite lately knocked at our doors and called several victims to the "undiscovered country" beyond the portals of "the silent halls of death."

What may be the purport or event of this menace, lies not in human wisdom either to predict or to control. Much may be done by way of hygienic precaution, much by sanitary regulations, but the spell is not put down at human bidding, and its mystery is still unsolved.

Dr. Sims in Paris.

Mr. Sampson Gamgee, one of the ablest British surgeons, and who is now visiting the French capital, is contributing to the Lancet a series of articles entitled "The Present State of Surgery in Paris." From the number found in the Lancet of September 7th, we find this reference to our justly eminent countryman, Dr. Marion Sims:

While on specialities, and before entering upon general surgery, I may relate the proceedings at a s' ance in the theatre of the Hospital Beaujon (August 30th,) when Dr. Marion Sims gave a demonstration of his methods, at the invitation of M. Richard. Among the large number present were Dr. Hingston, surgeon to the Hotel Dieu, Montreal; Prof. Pope, of St. Louis, U. S.; and Dr. Mazzoni, of Rome. Among the patients examined were several who had been operated on by Dr. Richard, to use Dr. Sims' expression, with the most perfect result. No case for actual operation presented itself that morning, but nevertheless the skillful manipulation was a most instructive one; and I beg to thank Dr. Marion Sims for the patience, candor and courtesy with which he answered all my questions.

For all examinations and operations on the vagina and uterus Dr. Sims uses the duck-bill speculum, and no other. He dislikes sunlight, and prefers light entering from one window directly at his back, to light entering the room from different quarters. The previous evacuation of the rectum greatly facilitates the use of the speculum. A table about four feet long, covered with a blanket, is preferable to a bed or couch for the patient to lie

upon. The position is on the left side, body diagonally to the table, so that the buttock rests on the left of the angle next to the operator and the window. The spine straight with the head, which may be raised very slightly if more agreeable; not so the shoulders, for the chest must lie prone, and as flat as possible on the table; neither of the arms under the chest, but well apart. The thighs to be bent at right angles to the trunk; legs at similar angle, an assistant raising the feet slightly. For this purpose a small table, a little higher than the one on which the patient lies, is handy to rest the legs upon. It is convenient to flex the right thigh a little more than the left, so as to bring the right heel just in front of the left ankle. In this position the epigastrium is on a lower level than the pelvis; and great importance is attached to the waist being free from all constriction, so that the abdominal viscera may gravitate freely forwards and downwards, and allow of the entrance of air into the vagina when the speculum is introduced. As already observed, this position is the invariable one for all inspections and operations. But one exception is made. When the patient has cancer of the womb, in order to avoid hemorrhage or other accident from striking the cervix with the speculum, this is introduced while the patient is on her knees on a table, the chest prone and the back con

cave.

Before using the speculum, Dr. Marion Sims invariably ascertains the size, position and direction of the womb; and he does this, while the patient lies on her back, by left digital examination, palpation with the left hand above pubes serving to bring the uterus well within reach.

Whenever he introduces anything into the uterus, be it a sound or a tent, a syringe or a knife, he fixes the curvix with a tenaculum, after introducing the speculum, and is thereby enabled to ensure steadiness, and, when necessary, to draw down the neck of the womb into the vagina, and so direct it as to at once see into it. It is only when he so fixes and sees it clearly that he divides. the cervix, thus making it an accurately surgical operation, and not merely a mechanical one. In operating for fistula, he always fixes the vaginal wall with a tenaculum before paring it or passing sutures.

Dr. Sims does not share the opinion of French surgeons that the climatic and general conditions of Paris are unfavorable to the healing of wounds. I have much pleasure in adding that, in examining the series of patients so liberally placed at his disposal by Dr. Richard, Dr. Marion Sims was no less skillful in his manipulations than he was careful for the feelings, mental as well as physical, of the poor women.