where the bird was perched, rebounded at an angle of about thirty degrees and struck the little girl, crushing the skull just above the ear. The child was one hundred and eight yards from the tree, dipping up water at a spring, and could not be seen from the spot where her father was standing when he shot at the bird. The child fell, but got up and walked some distance. We removed the fractured bone and a tablespoonful or more of brains escaped, but we could not find the ball. We were not

sure it had not again rebounded after crushing the skull. The case has done well from the beginning and we hope for a speedy cure. The gun used was an old-fashioned cap and ball" rifle, using about one hundred balls to the pound of lead.

Kendrick, Miss. C. KENDRICK, M. D.

Inversion of Uterus.

EDITOR MEDICAL WORLD:-Mrs. M., age about 36, married 14 years, 8 children, 6 miscarriages, was delivered at 6 a. m., May 21; I saw her in consultation at 2 a. m., May 22. There was a history of comparatively easy labor with adherent placenta. On attempting its removal, the attendant stated that she went into . a state of collapse. When I saw her the placenta had been removed; there was no hemorrhage; pulse 140, On examination a large pyriform mass was found filling the vagina to the vulva; the parts were extremely tender, so much so that the examination at that time was

necessarily incomplete. After anesthetizing her, and pushing slightly upward, a cup-shaped depression was plainly felt above the pubis. The inversion was found to be complete or of the third degree. In order to effect reduction the hand was introduced into the vagina lightly grasping the inverted mass, the fingers being extended and placed about the most constricted portion of the inverted mass so as to reduce first that part which was last inverted.

The greatest difficulty was in starting the reduction, as, when about half replaced, it suddenly, with an audible sound, assumed its normal positlon, remaining, however, somewhat flabby. During the efforts at reduction the pulse ran up as high as 175 per minute, but by means of external heat and stimulants administered hypodermatically she rallied and an hour later spoke to those about, and made an uninterrupted recovery. Two points seem to me of special importance: Ist. Stric: antisepsis -(1-2000 bichloride irrigations, thoroughly cleansing the hands and genitalia), and 2nd. Endeavoring to replace first that part which is last displaced.

Bellwood, Pa.

B. B. LEVENGOOD, M. D,

Remittent Fever Complicated with Meningitis and Measles.

EDITOR MEDICAL WORLD:-C. S., male, age 81⁄2 years, was taken sick May 27th, complaining of frontal headache, slight vomiting. May

On

28th I was asked to see him. I found that he had been exposed to measles, on May 25th. He complained of headache, nausea, and said that he felt very sore to touch. I found his temperature 103°, respiration normal, pulse 110 per minute. His mother said that he complained of feeling very cold 24 hours previously, but did not seem to have a distinct chill. Bowels moved once during previous 24 hours; tongue heavily coated. I diagnosed remittent fever and ordered potass. brom. et antipyrin aa gr. v. every five or six hours; also quinine sulph., gr. v. every five hours. May 29th I saw the patient and found his temperature 101°; less headache; no nausea; other conditions same as on the 28th. I ordered continuance of treatment. On May 30th I saw the patient and found his temperature 99%; very little headache; bowels moved once during previous 24 hours. June 2nd the temperature was normal; slight headache; bowels natural. I omitted the quinine and continued the bromide. The patient had taken freely of milk all through the sickness. I ordered half a dram of whiskey every three hours, as he complains of feeling weak. June 4th I saw the patient, when I was informed that he had, on the day previous, three convulsions. I found him with sighing respiration, pupils dilated and unequal in size, temperature 100°; bowels moved five times during the previous 24 hours; taking plenty of milk with the whiskey. I ordered blisters behind the ears and potass. brom. gr. v. every three hours. On June 5th his condition was the same as on the day previous; characteristic boat-shaped abdomen. On the 6th the same condition and same treatment, with tr. digitalis gtt i every hour.

June 7th; does not notice anything; swallows very well. 8th, eruption of measles coming all over the face, chest and back; temperature 1032; pulse 120; respiration 30; he coughs considerably and swallows with difficulty. 9th, eruption out on all parts of the body; he does not notice anything; sighing respiration, 30 per minute; temperature 100°; pulse 140; 1oth, patient died at 3.30 p. m.

Now, what I want to know is, was it meningitis from the commencement or was it, as I diagnosed, remittent fever ? If so, was the meningitis due to measles not coming out, or what? JNO. TOPPIN, M. D.

Stony Point, N. Y.

Aneurism of Abdominal Aorta. EDITOR MEDICAL WORLD :—Dr. V. E. Lawrence, Halstead, Kansas, reports a very interesting case, in the Aug. number, page 291, and for his benefit I will report a case of aneurism of the abdominal aorta.

Mrs. B., age 38, married at the age of 15, gave birth to one child, walked to a protracted meeting, the distance of two miles, with her one year old child in her arms. After arriving she was very much prostrated. Physician was called. Diagnosis, over-heat. She was confined to her bed several weeks, and has never enjoyed good health since. I was called to see her April 3, 1891. She had been confined to her bed two months, under treatment of a quack doctor. His diagnosis was congestion of the stomach. He insisted on her taking consider

able exercise, and tried to convince her that a great portion of her trouble was imaginary. So his instructions were heeded by calling another

physician. After examination I very readily diagnosed my case aneurism of abdominal aorta. I put her on iron and tincture of nux vomica,

and left.

April 5th, returned and made a careful examination with the stethescope, which confirmed my diagnosis, the tumor being situated near the umbilicus. Pulsation at said point corresponded with each stroke of the heart. Her greatest complaint was suffocation and pain in the region of the heart. I explained to her husband the condition and the gravity of her case. I ordered that she be kept very quiet in bed, and, in addition to the first treatment, put her on moderate doses of iodide of potassium, to be given three a day. On the 19th, I met in consultation with another physician, and, after examination he accepted my diagnosis and suggested that we discontinue potash and instead, use ergot, which we did. April 26th, patient not doing well. Discontinued ergot and resumed iodide of potassium, and since that time have made it the basis of my treatment. April 29th, some improvement, and she has continued to improve gradually every since. Now, August 18th, pulsation at

umbilicus can scarcely be detected, and she is able to go about the house. Winnfield, La.

W. B. MASK, M. D.

Pancrobilin.-Cathartics in Typhoid Fever.

EDITOR MEDICAL WORLD:-The case of Mr. McClelland, published in your June number, brought me several replies, from Drs. Hightower, H. J. Whitney, F. W. Higgins and others, for which I am very thankful, as also for the suggestions of Dr. Waugh in August WORLD, and if I have occasion to treat Mr. McC. again I will surely try some of the treat

ments, and report. But I am very glad to say that my patient improved right along on the treatment I was giving him, and which I reported, viz., liquid pancrobilin (R. & C.) 11⁄2 hours after eating, and pills of nux vomica and cascara before meals, with a weekly dose of calomel and a bread and milk diet. He "got up" quicker than ever before, and is now as hearty and robust as any rancher you pancrobilin, for he had tried several times I give most of the praise to the

ever saw.

before the calomel and nux vomica and bread and milk diet.

Apropos of Dr. J. C. Campbell's article, "The Syringe vs. Cathartics in Typhoid Fever," I would say that my plan has usually been to give calomel, never over 5 grs., at the beginning, and afterwards to keep the bowels reasonably quiet. Lots of fresh air, a breeze, if possible, has been my hobby, and not too much nourishment. Small quantities regularly administered. But I wish to speak particularly

of one case. Mrs. S., aged 65, a chronic after nursing two of her family through the invalid, during an epidemic of typhoid in '82,

fever, contracted it herself. She had diarrhea from the beginning, and it was hard to control. At the end of two weeks she had a hemorrhage from the bowels, followed by rapid sinking. She became comatose, her chin dropped and she looked like death itself. She remained in this condition 12 hours, "slowly dying," as her husband expressed it, though, of course, I ordered the stimulants to be kept up. The old lady always had been" yellow as a pumpkin," and as I looked at her I thought she looked more jaundiced than ever, and the conviction came over me that a dose of calomel would do "Calomel after long continued diarrhea and hemorrhage - hardly orthodox!" I thought. "Mr. S. your wife is nearly dead. I am going to give her a big dose of calomel as a last resort." "Doctor,, she told me yesterday that you would never get her up until you gave her calomel!" replied the old

her good.

man.

rhubarb, and with some difficulty succeeded in I fixed up 5 grs. each of calomel and washing it down her throat. I went home that night expecting to hear of her death in the On the contrary, morning. But I didn't. when I cautiously approached the house, the old man met me with a broad and happy smile -"Doctor, that calomel saved her!" The old lady was transformed, and I knew the moment I looked at her that she would get well, and she did.

Now, I don't wish to be understood as advocating cal. et p. rhic in all cases of diarrhea and intestinal hemorrhage, but I do believe that it was just what was needed in this

case.

Before closing, I wish to ask the significance of a "cranial bruit," I shall call it, though I never heard of one before. The subject is my own child, a boy just twelve months old, perfectly healthy, fine large and symmetrical head. The bruit was first discovered by my wife two months ago, and can be heard plainly over either temporal region. It sounds like the "whir" of a skipping rope rapidly turned. It is synchronous with the pulse. Will some one please explain it for me? Rivera, Cala.

W. D. GROTON.

men

EDITOR MEDICAL WORLD: In the matter of "Professional Courtesy," as tioned in your issue for September, 1891, I have the honor to call the attention of your readers to Section IX. of the by-laws of the Medical Society of the county of Clinton, State of New York, which, under Deportment, reads thus: "The members of this society, in their professional intercourse with each other, and with the community where they obtain their livelihood, shall be governed by the laws of polite society, being careful always to do unto others as they would be done by," and it is fair to add that this law is seldom or never broken by the members who have agreed

thereto.

Pin-Worms.

EDITOR MEDICAL WORLD:-The ascarides, one of the numerous family of the entozoa, can be most effectually destroyed by the use of a saturated aqueous solution of the best socrotine aloes. One ounce of this solution, injected into the rectum at bed time, retained as long as convenient. Thus use for several nights consecutively, then discontinue, and if there is any return of the parasite, use again in the same way.

I have never had a case to fail using the aloes as above. I prepare the solution with boiling hot water, and afterward use it at a temperature of about 98°, for the comfort of the patient.

WM NEPHEW KING, M. D.

214 West 44, New York City.

Make pill. This makes one dose, such dose to be taken at bed time every night, unless too much action on bowels, in which case miss a dose as occasion may require. This prescription gave me considerable reputation in the early days of my professional career, and has never disappointed me since. Prescott, Ark.

R. L HINTON, M. D.

Powder Burns.

EDITOR MEDICAL WORLD:-The writer has treated successfully many acute cases of "powder burn" in the following manner. Suppuration occurs in a few days, and when in proper stage, an emollient poultice is applied for halt-hour or longer, then a sharp razor is passed over

the surface, which cuts off the softened elevations containing the powder grains and exposing the grains. A stiff sponge of selected texture, as to meshes, is passed over, and by mopping, &c., the grains and coloring matter become engaged in the meshes of sponge; the latter is cleansed, and the wiping and mopping repeated until the coloring matter is absorbed by the sponge.

The application of the mucuric-bichloride solution would probably produce the desired inflammation and suppuration, thus fitting an old case for similar treatment.

To prevent cicatrization marks as much as possible, use a constant dressing of glycerine and water, or glycerole of starch.

Larvæ of House Fly Infesting an Infant. EDITOR MEDICAL WORLD:-I have recently. had a case of larvæ similar to Dr. A. J. White's in August WORLD, which may be of interest to the profession.

I pro

On August 1st, last, Mr. N. R. sent me a "worm" for identification, which had passed that day in the alvine discharge of his baby, aged three months. On August 4th he brought me another one of the same species. nounced them as the larvæ of some species of fly, and to prove to Mr R's. doubting mind, I put both worms" into a small vial for further development. One of the "worms" died, the other, the next day after its arrival, changed into the pupa state, and five days afterwards, hatched out a fully developed housefly-musca domestica. The baby had passed eight of the larvæ from its bowels up to that time. It had been fed partially artificially, which accounts for the egg or larva being conveyed into its intestinal canal. Mr. R. also told me, and I will use his language as nearly as possible. "After the navel string c me away, we found that the maggots had got into the baby's navel; they were very large (measuring from the end of his finger about 3/4 inch) and two layers deep lengthways and as tight as they could be packed."

Saulsbury, Tenn.

W. L. GODDARD, M. D.

Ergot in Labor-Still Births Heralded by Dream or Other Presentiment-Chloride of Zinc for Cancer.

* EDITOR MEDICAL WORLD :—I have been a constant reader of your valuable journal for three years, and have tried many remedies and new lines of treatment as suggested by THE MEDICAL WORLD family, and in most cases have received valuable aid. There was one article in 1889 WORLD, page 30, however, that got me into trouble.

This is what the author said: "I give a tittle ergot to settle things and see what is to be done. Sometimes this results in making more pains, sometimes in making less, if it makes more I increase the ergot and get through with the case,"

This had a different jingle from anything I had ever read before, and it fastened itself on my mind. I have tried it several times with that thought constantly coming over in my mind, that if it did not make more pains it experience it always has the power to make would make less and "settle things." In my more pains (never less), but exactly the kind we do not want, a tonic spasm with a clonic exacerbation, and after the second stage of labor is completed you will find that it "settles things" unless you resort to artificial respiration without loosing any time. These are cold facts as far as my experience goes, and I now hold that ergot should never be used as long as there is anything in the uterine cavity.

While I am on this subject I may say that I have had several cases of still-births, as most all practitioners will have, and in every case when discussing the cause, the mother has told me that she has had a presentiment in a dream some time before, and that she had expected

trouble ever since. I am not a believer in the mysterious, but this has happened so often in my practice that I can not help but notice it, and wonder if other practitioners have the

same.

I have just completed the removal of a carcinoma of the epithelial variety by chloride of zinc, made into a paste by addition of an equal amount of flour and a little water, as suggested by the MEDICAL WORLD. Its removal required but four days.

Sciotoville, Ohio. J. A. CHAMPION, M. D. Champion gives in regard to ergot. [We have tried to teach the same rule as Dr. Editori ally we do not endorse everything that appears in the communications.-ED.]

Sciatica.

EDITOR MEDICAL WORLD: - If Dr. E. H. Carlton wishes a remedy for sciatica that will relieve all cases and cure 80 per cent., I will call

I have practiced medicine twenty.three years and have treated many cases of sciatica with all kinds of remedies, i. e., hypodermics, blisters, hot and cold applications, electricity, both galvanic and Faradic currents, sun baths, with all the different colored glasses, &c., &c., but I have found that the little drop of croton will get away with all the other remedies combined. By inducing immense watery discharge from the bowels, it relieves the congestion and thus cures the patient. Try it and report. S. J. CORBETT, M. D.

San Francisco, Cal.

La Grippe-Origin, History, Treatment. EDITOR MEDICAL WORLD:-This disease is sometimes called Russian Influenza, because it is supposed to have had its origin in Siberia It usually occurs as an epidemic and travels rapidly over the globe. It has received many names, the most common being Influenza and La Grippe. The Italians in the seventeenth century called it influenza, supposing it owed its origin to some occult influence of the stars. La Grippe is said by some to come from the Polish Crypka, meaning "hoarse"; others recognize it in the French word "gripper," which means "to seize"; the Germans call it "blitz katarrh." It has been known in Europe since the fifth century, and invariably sweeps over the country from East to West. In the recent universal epidemic it travelled from St. Petersburg to New York in about six weeks. Its etiology is shrouded in mystery, although the generally accepted theory is that it is bacterial in its origin. The diplococcus pneumoniæ and the streptococcus pyogenes are the usual varieties of bacteria of the atmosphere. The streptococcus seems to be the species that is usually found to predominate, and in some cases is found alone. I take it that the disease

is beyond question infectious, and spreads by atmospheric influences. Many examples are to be found in the current medical literature which could be cited to prove the assumption; also the experience of most physicians during the recent epidemics among their clientele was in this direction. Some investigators claim, however, that it is contagious, and regard it as a contagio-miasmatic disease capable of being conveyed from place to place and from person to person. I am of the opinion, however, that there must be receptivity, else why should some escape?

It attacks persons of all ages and conditions, although children are more apt to be exempt. The micro organism seems to act specifically upon the mucous membrane of the respiratory tract with which it comes in contact.

Humidity of the atmosphere seems to have much to do with its development. Altitude seems to make little difference. It is seen in the valleys of large rivers and high up in the mountain ranges; under the snows of Scandinavia; under the suns of the Equator, as well as on the islands of Polynesia; in the house and in the palace; in the busy mart and in my lady's boudoir.

Greenley, in the American Practitioner and News, of Louisville, Ky,, says: "Influenza is independent of hydrometric, thermometric and barometric changes."

Prudden finds certain kinds of bacteria. Marmorek, in addition to these, finds several other kinds, axd doubts the investigations of Ribbert, while Babes and Kowalski see others which no one else has described. Klebs, in examining the blood, finds abnormal bodies; Kollman finds additional ones, while other bacteriologists report negative results. In my opinion, influenza is due to a definite microorganism which is in the atmosphere under certain conditions and at certain places, which conditions of the atmosphere last for a longer or shorter period. When these micro-organisms come in contact with the mucous membrane of the respiratory tract, if the conditions are such that they find lodgment, then the disease is manifested. Now, whether the pneumococcus, the streptococcus or the staphlococ cus, collectively or individually, is the cause of influenza, I am not able to say, and proof has not been forthcoming from investigators which is reliable and settled. The Pathogenic bacillus of influenza has as yet not been definitely recognized, notwithstanding the worthy labors of Tomasi-Crudelli, Klebs and others. My intention is not to condemn the investigations that have taken place in this direction, far be it from me. I am a firm believer in the germ theory of the disease. Some go so far as to say that the disease cannot be caused primarily