TRADE Liquid Extract of Malt Is made from the best Canadian Barley Malt. Is richer in Diastase and Maltose than any other made. Is guaranteed free from foreign matter such as Glucose, Licorice, Salicylic Acid, etc. Is put up in 16-ounce bottles to retail at 25c., 30c. per dozen being allowed for empty bottles when returned. Please note the difference in size of "O'Keefe's" bottles as compared with other makers. W. LLOYD WOOD OAKLAND TORONTO CHEMICAL COMPY MARK Oakland Hydrogen Dioxid, U.S.P. "THE KIND THAT KEEPS." This perfected product thoroughly meets the demand of the medical profession for a strictly reliable preparation of H,O, suitable for all medicinal purposes. It is a powerful antiseptic and germicide, free from harmful qualities. Its internal use is highly recommended to promote intestinal antisepsis (infantile diarrhea, fermentive dyspepsia, etc.). Externally it is used as a prophylactic and for all suppurative and inflammatory processes. THE OAKLAND CHEMICAL COMPANY 465 and 467 West Broadway, NEW YORK AMYLOLYTIC FERMENTS. In an article on this important subject Wyatt Wingrave, M.R.C.S. England (Assistant Surgeon to the Central London Throat and Ear Hospital), in the London Lancet, May 7th, 1898, we are informed of a personal necessity that arose in the writer's experience for a reliable starch digestant. A crucial comparative examination was therefore made of many malt extracts and of Taka. Diastase, the tests being conducted both chemically and clinically. He summarizes briefly: (1) That Taka-Diastase is the most powerful of the starch or diastatic ferments and the most reliable, since it is more rapid in its action, ie., "it will convert a larger amount (of starch) in a given time than will any other amylolytic ferment." (2) That Taka-Diastase seems to be less retarded in its digestive action by the presence of the organic acids (butyric, lactic, acetic), and also by tea, coffee and alcohol, than are saliva and the malt extracts. This is an important point in pyrosis. (3) That all mineral acids, hydrochloric, etc., quickly stop and permanently destroy all diastatic action if allowed sufficient time and if present in sufficient quantities. (4) That Taka-Diastase and Malt Diastase have, like ptyalin, no action upon cellulose (uncooked starch). All starch food should therefore be cooked to permit of the starch ferment assisting nature in this function. 7 he treatment of Diabetes Simplified by the use of BULEXINE Non-toxic; no functional trouble; no stomachic disturbance. EULEXINE Aromatized (R-Liquor Eulexini Aromaticus) in four-ounce unlettered glass containers for filling physicians' prescriptions. FORMULA-Eulexine.... Rhamnus Purshiana Rigid diet not essential when this preparation is employed. Postal for Clinical Reports 10 per cent. 20 per cent. q.s. THOMAS PHARMACAL COMPANY, W. LLOYD WOOD, TORONTO. ΙΟ 95 Broad Street, New York. אן MANAGER ADVERTISING DEPARTMENT: MR. W. LLOYD WOOD. PUBLISHERS: THE PRACTITIONER PUBLISHING COMPANY, TORONTO. DECEMBER, 1898. [No. 12. Original Communications. THE SURGICAL TREATMENT OF INSANITY. BY ERNEST HALL, Fellow B.C. Gyn. Society, Victoria, B.C. N THE CANADIAN PRACTITIONER of April I made a preliminary report upon a case of insanity of two years and ten months' duration which was relieved by removing diseased appendages. It is satisfactory to report at this period, more than nine months. since the operation, a continued physical improvement, the patient having gained thirty-five pounds in weight, and what is still better she has been completely restored mentally and is. again a useful member of society. Since treating this case I have examined eleven insane women with the result of finding abnormal conditions of the pelvic organs in nine instances. In six of these cases surgical measures were adopted with results upon the whole satisfactory. One case of exceptional interest is here given. PRELIMINARY REPORT. Mrs. R., aged 52 years, married 29 years, never been pregnant, husband healthy, mother melancholic; one brother committed suicide at the age of 45 after the death of his wife; brother suffered from religious mania and upon two occasions endeavored to take his own life, but for the last twenty years has manifested no indications of insanity. Two uncles of the patient died in Bodmore Asylum, Cornwall. The patient had been healthy until fourteen years ago, when she suffered from an attack of so-called ovaritis upon the right side. She was considered very sick, and was confined to her bed for six weeks. She had complained of continual pains in the right side. Bowels sluggish. HISTORY OF THE INSANITY. Eight years ago the patient first manifested indications of mental disturbance, after reading some religious works on the doctrine (?) of sanctification. As she did not feel as the writer described, she was not "sanctified," and in order to be good she must experience these peculiar sensations. After a few months she became rational again, remaining so until three years ago last February, when she again shewed symptoms of insanity, with similar characteristics. She considered it was her duty to give up everything for the "Lord." She gave away a certain amount of her jewellery. Then the "Holy Ghost" told her she must give up that which was dearest to her; that being her husband, she was asked to give him up and unless she did so she had not reached the desideratum. She told her husband repeatedly that there was a danger of her killing him, as the "Holy Ghost" had told her that since she had made her hus band her idol she must kill him. She also attempted suicide, and wandered away from ner friend's house and was found near the seashore. At this time she came under my observation, and upon this finding she was admitted to the Provincial Insane Asylum on June 19th, 1896, where she remained until October 5th, 1898. Her asylum life was characterized by an intensification of religious delusions, with melancholia. She refused to recognize her husband, and said she was not married, that his wife was 'dead, etc. She also suffered greatly from insomnia. One year ago, while visiting the asylum, through the courtesy of the medical superintendent, Dr. Boddington, and with the consent of the husband, I made a pelvic examination under anaesthesia, finding the uterus retroverted, with dense adhesions. I could not determine either right or left ovary. Upon the result of this examination, I recommended operative measures, but on account of conditions unnecessary to here state I was not allowed to operate until October 5th, 1898. The patient offered no objections to taking anaesthetic, and the last words she said as I commenced it were: "You look like a preacher; I have no need for you, I have no soul." After commencing the anaesthesia, I gave place to an assistant and prepared for the operation. Conditions found: Adhesion of the clitoris with retention of smegma as large as a small pea. Dilated and curretted without finding any abnormality. Abdomen was then opened, and the omentum was found adherent to the parietal peritoneum for about six inches along the median line. The pelvis was one mass of adhesions, and it was with the utmost difficulty I succeeded in freeing the uterus from the sacrum and the bowels. The left ovary and tube were found in a mass of adhesions, and with difficulty were removed. Upon the right side the adhesions were so dense that I was unable even to find the right ovary. The uterus was brought forward and ventrofixed, and the abdomen closed without any drainage. Convalescence normal; stitches removed on the twelfth day. Physical: RESULTS. Patient rested well after operation; slept a few hours the first night. Second day satisfactory; somewhat restless upon the third day. Sixth day she passed several large concretions of fæcal matter which appeared to have been lodged for some time in the bowel. Ten days after she experienced uneasiness in the bowel, and an examination revealed the presence of several additional concretions-one so large that it required to be forcibly broken before removal. Patient sat up in bed beginning of third week. Physical condition rapidly improving under tonics. Mental: There appeared to be a marked change in the mental condition immediately upon awakening from the anaesthetic. During |