heat, allowing a little for the cooling effect of the tissues to be acted upon. The tampon being removed, and the parts dried with cotton, make the cautery application carefully, until the enlargement is sufficiently removed, being careful not to go too far, as the tissues will contract somewhat in healing. The operator can see just what he is doing, as there is no bleeding. Some small hypertrophies may be treated with chromic or other strong acid, but the cautery is preferable in large growths. Treatment of Hypertrophied Tonsils by the Galvano-Cautery. WHAT was said in the preceding article regarding the degree of heat to be used, applies with equal force here. Some operators use a black heat, but I prefer a very dull red, just plainly perceptible. In a paper upon this subject, by Dr. Gilbert I. Cullen, of Cincinnati, read in Washington in May last, the author recommends, in some cases, the entire removal of the tonsils, by means of the galvano-cautery snare. For puncture he uses an electrode that corresponds with the size of the lacunæ, one requiring some slight pressure to insert it into the crypt. This is good practice. He also calls attention to the fact that both the internal and external carotid arteries lie in close proximity to the tonsil, the former being about one half an inch, and the latter three-fourths of an inch from the gland. These distances may be increased, however, by making traction upon the organ. After the operation, the parts may be sprayed with any antiseptic soothing solution. In cases of after hemorrhage from galvanopuncture, which are very rare, the author recommends the use of a mixture of tannic acid two parts, gallic acid one part, and water sufficient to render it the consistence of thick cream. The main indications for reduction of tonsils by galvano cautery are summarized as follows: I. "When tonsils have ceased to perform their function by reason of interstitial thickening and occlusion of the lacunæ of the glands, in which condition the mouths of the crypts becoming blocked with the accumulation of sebaceous matter, which rapidly decomposes, they form an excellent culture medium for various pathogenic germs which may ultimately be absorbed into the lymphatic system. II. That when a tonsil shows itself competent at short intervals to become inflamed and give rise to peritonsillar abscess. III. Where the tonsil is so situated that it is a matter of great difficulty as well as danger to use the tonsillotome, and from extensive adhesion of the pillars, likely to cause severe hemorrhage by their being cut. IV. "In all cases where the patient is of a hemorrhagic diathesis or in other cases in which alarming hemorrhage is feared. V. "Where patients will not consent to the use of the knife and yet the demand for the removal of the gland is imperative." WM. H. WALLING, M.D., Philadelphia, Pa. Cathartics in Typhoid and Eruptive Fevers. EDITOR MEDICAL WORLD:- I have been much interested in the articles on typhoid fever, in August No. of THE WORLD. I think Dr. Campbell has hit upon a fine and unique plan to "reform," and to " harmonize" treatment of disease in accordance with the pathological condition of the system, and therapeutic effect of remedies. Now, to my mind, however wrong I may be, nothing is more inconsistent than to give physic in typheid fever, 'small pox, measles, or, you may say, in any of those self-limiting eruptive diseases, after having first cleared out the alimentary canal and given some impetus to the liver, perhaps, and so prepared the system for the use of such auxiliaries to motion as the physician may have learned by experience and observation are best suited to the case. My rule has been generally, in all of these cases, to give calomel, soda and rhubarb, suited to the condition of the case, enough at best to empty the bowels, and see that a reasonably fair evacuation takes place, sometimes using an injection to further or hasten progress. Subsequent treatment is aconite, belladonna, bromide of potash, quinine, and some mild saline aperient, just enough and no more to prevent an injury to the system by waste material that might accumulate therein through the efforts of vis medicatrix naturæ, and to see that the secretions are in a reasonably active condition. Of course, in the later stage of typhoid some turpentine emulsions and spiritus frumenti, especially in typhoid pneumonia, are very excellent aids to bridge over the approaching crisis. But, to digress somewhat, I cannot close this article on cathartics without further alluding to eruptive diseases, such for instance as measles and small-pox. In those diseases, especially, is physic positively hurtful, after first clearing out the alimentary canal. The system being already taxed to its utmost to rid itself of the disease, while an auxiliary may be a benefit, it is not so certain, that, assuming to do all by the physician, without any reference to the efforts that the human economy is I SHALL not here attempt to vindicate the advantages of ocytocy. My object in the following observations is to show how rapid parturition is effected. The modus faciendi, as will be seen, is easy. The maneuvers are absolutely inoffensive. It can then be said of this method, that it helps the shrewd obstetrician to obtain his object cito et tuto. First observation: Artificial parturition in one hour: Mrs. X., primipara, aged 20 years, of excellent constitution. Labor in advance of twenty days, probably due to a fall the week previous. Loss of the waters during the night of 11th to 12th of October, 1884. Slow dripping of the amniotic fluid the next day. On the 12th, at half past nine, on my visit, I noticed extreme weakness. Contractions insignificant. The neck orifice opening of 0.02 (4-5 inch). I wait patiently for the wakening of the pains, in no way apparent, until half-past ten, when my interference is called for. The neck is a little flattened, but the dilatation has made no progress since my coming. As there was nothing to gain by waiting, I proceeded to ocytocy in the following manner: Administration of the ocytocic granules, hyosciamin and sulph. of strychnine, one of each every ten minutes. Six doses were given. Copious inunctions of the maternal organs with unsalted lard to render the vulva supple and more promptly permeable, and at the same time to incite reflex action. Methodical digital dilatation of the cervical orifice. Immediate wakening of the pains. Under the influence of these simple means, at eleven, the permeability of the neck was such as to permit the application of the retroceps. Ineffectual tractions from resistance of the parts force me to adopt the tractor to the retroceps, and at half-past eleven, after making a perineal incision of 0.01 (2-5 inch).to facilitate the passage of the head, I extract a very lively girl, weighing nine pounds. Delivery very easy. To guard against any flooding, I make two injections of ergotinine, each of o o1 (11⁄2 grains) on the buttocks. The sequence was on all points physiological. This case can be considered a type of otytocy. At half-past ten the patient feels but slight passing pains; the cervical orifice open of only 0.02. One hour after, extraction of a child full of life. The divers elements, which concurred to this prompt and successful delivery, were : Ist. Administration of the ocytocic granules to hasten the dilatation of the cervical orifice. 2nd. The copious use of lard to soften the maternal organs and render them more permeable to the obstetrical instruments. 3rd. Digital dilatation of the cervical orifice. 4th. Application of the retroceps as soon as the aperture of the neck permitted the introduction of the narrow and strongly arched branches of the 'instrument. 5th. Association of the tractor to the retroceps to prevent twitchings to the mother, all violent trippings of the branches, as also all fatigue to the operator. In the combination of the divers elements just mentioned, is seen what generally happens in the practice of ocytocy. But it is not always So. And it is to the judicious obstetrician to discern the indications which may present themselves in a given case. The principle of ocytocy is the same; but the modus faciendi can and must evidently vary in the applications. Thus, in the majority of cases the retroceps is the only instrument needed. But, it can also happen, by exception, that this instrument cannot be used at all. When it is so, without hesitation another instrument must be employed. To illustrate this, I will give another type of ocytocy, in which, after using my instrument, it had to give way to the old traditional forceps. The observation comes well after the preceding one, as it will show how the obstetrician worthy of the name ought to act, and who, by principle, should be free from all passion or prejudice. On several points this observation is more interesting than the preceding one. It constitutes in another way a finished type of ocytocy. 2nd observation: Artificial parturition in one hour and a half- -crural phlebitis-rapid jugulation. Mrs. Y., primipara, aged 27 years. Lympha tic constitution. Having full confidence in me, Mrs. Y. had often consulted me during her pregnaney. At the term of six months, she suffered from an attack of acute metritis, for which I had to use leeches. At the beginning of this labor, this young woman, under a strange nervous mania, conceived such a dread of any intervention from me, that, placing herself under the care of a midwife, given to her by myself as a nurse, thought she could dispense with my services. It was only after forty-eight hours of intense suffering, and the spontaneous breaking of the waters at 6, that she decided to call me to her assistance, on the 1st of September, 1884, at 82. I found the neck thick, open of 0.03 (1 1-5 inches) com- || plete inertia of the uterus, the patient extremely nervous. I gave the ocytocic granules. Large inunctions with lard, methodical digital dilatation of the neck. At half-past nine application of the retroceps very deeply engaged. Association of the tractor, tendency to trip. Reapplication of both instruments, but still a tendency to trip. To what is due this, I can assure, exceptional occurrence? Without trying to explain the cause of these unsuccessful attempts, I immediately seized my big forceps and endeavored to place it in position. It was a left oblique application and it was some time before I could succeed. With the aid of the mechanical tractor, I brought the head down on the perineal floor; then, taking out the instrument, with my hands I made the extraction of a very lively girl, weighing eleven pounds. It was 10 a. m. All the maneuvers had then lasted but one hour and a half. The failure of the retroceps was due to the elevation of the head, strongly ossified, which, insufficiently engaged across the strait, could not find against the pubic arc the support necessary to the special mode of action of the retroceps. This is a case in which the instrument is at fault, and I have taken care to mention it in my several works. The con ditions are exceptional in practice; but yet it is necessary to be made aware of the fact, so that one may know what to do when it is met with. Generally, substitute for the retroceps, which is an agent of reduction par excellence, an instrument acting differently and having for its object the direction of the head diametrically and solidly seized, and yet, even in this case, the retroceps was of some use. Its narrow branches, and its unequalled facility of articulation, made it of use when it would have been impossible to use the forceps. It is these so very favorable conditions of intromission and handling which render the use of my instrument so advantageous, that it can be considered the corner-stone of ocytocy, to the practice of which, without it, one must not even think of. This first particularity makes this observation already interesting. There is another of equal interest still to be related. On the 3rd of September the patient complained of not being able to move the right leg. On examination, I found a crural phlebitis. Incipient phlegmasia alba dolens. Thorough painting of the leg with collodion flexile, wrapping of the entire member with a thick coat of cotton wadding, sedlitz to keep the bowels free. She complains of severe pains from the high part of the thigh to the foot. To be short, on the 10th she could move the leg; on the 14th she left the bed, and could walk trailing the foot; a few days more she was perfectly well. By this simple, but opportune treatment, I succeeded in a few days in jugulating a grave complication, which sometimes will last more than a month. Two words more about weaning, which I had to do in this case, the patient, from her position, not being able to suckle her child. To prevent the rising of milk, I employ, always with success, the following means: 1. Large administration of the sedlitz salts; 2. inunctions and applications on the breasts of camphorated linseed oil with a heavy layer of cotton wadding on the parts; 3. A five ounce potion containing five grammes (45 grains) of iodide of potassium, a tablespoonful night and morning. Again, I recommend this simple medication as being very efficacious for all women who cannot nurse their child. These two observations will no doubt be sufficient to give an idea of the manner in which I practice ocytocy or rapid parturition. I always proceed in that way. For years I have derived great advantages from this method, and I have not yet a single mishap to fecord. No one, I am sure, will think of attributing to rapid parturition the phlebitis which followed. Two facts could be signaled as the cause of this complication. The mother of the patient, herself lymphatic, suffered of crural phlebitis after her unique parturition. The labor, very ineffective with Mrs. Y., was already of 48 hours duration, when I intervened. Besides, phlegmasia alba dolens is often observed after the most physiological parturition. In its production, idiosyncrasy, it seems, must ordinarily be considered. DR. L. HAMON DE FRESNAY. Translated from the French for THE MEDICAL WORLD by D. Tureaud, M. D., New Orleans, La. Cannabis Indica-A Sad Experience. The EDITOR MEDICAL WORLD:-We read in the chronicles of former centuries how in the night of St. Walburgis, the witches of Germany celebrated a grand rendezvous on the yet famous Bloxberg or Witch Mountain. funniest thing of all, they rode there on broomsticks, greeted loud and lively as they passed each other over moors, woods and rivers. By and by they could hear the lively waltzes on the hill and the patter of the feet of the votaries of the fantastic toe. And why not? not happened that on Good Friday all the little and big bells of our villages had flown to Rome? All this flying and moving I have never doubted in the least, since once I took ten drops of the fluid extract of cannabis indica. Sapienti sat. I took it at about 6 p. m., and by 8 p. m. I was to make a speech to our Woman's Mission Association. Has it The hall (basement) was well filled. When I entered, I wondered whether the hall was broad enough for anything. Texts were plenti ful, but should I sing them or recite them in prose? My greatest difficulty was how to keep quiet, and how could I, when both of my feet commenced to go up. swung right and left, and tried to steady myself between two high chairs. I knew I was off the floor all the while, and to call my speech "eloquence,' was not doing it justice. Next morning, meeting some of the members, I asked their pardon for any mistake I should have made. They were all perfectly satisfied, and never noticed anything wrong. Beware of cannabis. P. A. MOLLING, M. D. Cleveland, O. Formulas. FOR WORMS IN CHILDREN. M. Washed sulphur. Salicylic acid. PNEUMONIA. .2 drachms I drachm 15 grains I ounce. -Med. News. Dr. Hodge relates the value of ergot in contracting the blood vessels in the first and second stages of pneumonia. He gives the following formula: R Ext. ergotæ fl Tinct. Gelsemii .4 drachms 2 drachms 2 drachms M. Sig. Thirty two drops every two hours, to be increased if necessary.-Peoria Medical Monthly. LIQUOR SODII BORATIS COMPOSITUS.-COMPOUND SOLUTION OF BORATE OF SODIUM.— (DOBELL'S SOLUTION). B Borate of sodium Bicarbonate of sodium Water enough to make 16 fluid ounces. Dissolve the salts in about eight fluid ounces of water, then add the glycerin, and the carbolic acid previously liquified by warming, and lastly, enough water to make sixteen fluid ounces. ABORTING PNEUMONIA. THE following treatment is reported by Rossiter in the Medical Record, May, '81, as Schneegans and Corneille (N. Y. Med. Jour.) aborting pneumonia (acute lobar) in its very give the following formula: earliest stage: The patient is given a hot pediluvium and some mild counter irritant; then: ANNUAL OF THE UNIVERSAL MEDICAL SCIENCES FOR 1891. 5 volumes, cloth, price $15. F. A. Davis. Phila. This work is steadily sustaining the reputation it achieved in the first year of its publication. The various departments are in the hands of competent and even eminent men. For the information of any who may not have had opportunity to examine this work in previous years we will state that it is a yearly publication giving a resume of the best contributions of the year in medical journals and other periodical publications. By Oswald Vierodt, M. D., of Heidelberg, Ger- The successful physician must make profound, daily and continuous study of diagnosis. To the few really good works on the subject we are glad to add this one. A work on diagnosis does not grow old as rapidly as one on treatment, and, as you must take the views of several different authors in this department, we think this is one of the books you really must have this year. THERAPEUTICS: ITS PRINCIPLES AND PRACTICE. By H. C. Wood, M. D., LL. D, of Phila. 8th edition. Cloth, $6.00. J. B. Lippincott Co., Phila. The popularity of this work is shown by the large demand for it. This popularity is founded upon the scholarly perfection of the work. In this book thera peutics is based largely upon physiological observations. Prof. Wood has done much to advance the science of therapeutics. SYLLABUS OF OBSTETRICAL LECTURES, UNIVERSITY OF PENNSYLVANIA, By R. C. Norris, A. M., M. D., Demonstrator. Cloth, $200. W. B. Saunders, Phila. This is the second edition of a work presenting the teachings in this subject at the University. A CLINICAL STUDY OF DISEASES OF THE KIDNEYS. By Clifford Mitchell, A. M., M. D., of Chicago. Published by W. T. Keener, 96 Washington St., Chicago. A thorough and practical work on this very important subject. The therapeutics especially, is good. STORIES OF A COUNTRY DOCTOR. By Willis P. King, M. D., Kansas City, Mo. $1.00. Hummell & Parmele, 612 Drexel Building, Phila. A thoroughly enjoyable work, giving a true picture of a doctor's life among pioneers in a new country. The publishers deserve credit for placing the work in its second edition at a price easily within the reach of all. The former price was $2.50. THE POCKET MATERIA MEDICA AND THERAPEUTICS; a Resume of the Action and doses of all Officinal and Non-officinal Drugs now in Common Use. By C. Henri Leonard, A.M., M.D., Professor of Medical and Surgical Diseases of Women and Clinical Gynecology in the Detroit College of Medicinc. Cloth, 12 mo., 300 pages; price, postpaid, $1.00. The Illustrated Meaical Journal Company, Publishers, Detroit. This volume, so the preface informs us, has been in preparation for the past four years. The drugs of as late introduction as 1891 are to be found in its pages. The author claims to have incorporated everything of merit, whether officinal or non-officinal, that could be found either in standard works or from many manufac turers' catalogues. The scheme embraces the Pronunciation. Officinal or Non-officinal indication (shown by an*), Genitive case-ending, Common Name, Dose and Metric Dose. Then the synonyms, English, French and German. If a Plant the Part Used, Habitat, Natural Order, and Deseription of Plant and Flowers, with its Alkaloids if any. If a Mineral, its chemical Symbol, Atomic Weight, looks, taste, and how found, and its peculiarities. Then the Action and Uses of the Drug, its Antagonists, Incompatibles, Synergists and Antidotes. Then follow its Officinal and Non-officinal preparations, with their Medium and Maximum Doses, based so far as possible, upon the last U. S. Dispensatory. Altogether, it is a handy volume for either the Physician, Student or Druggist, and will be frequently ap It is the most compealed to if in one's possession. plete small book on this subject now issued. MASSAGE PRIMER. By Sarah E. Post, M. D. $1.00. The Nightingale Pub. Co., 13 W. 42nd St. N. Y. This is not a compilation of cases, but consists of solid instruction arranged for use a text book in three parts. The first is devoted to a description of the motions of massage, giving the various stroking, kneading and percussing motions. The second is devoted to general massage, giving the minuter details in regard to the management of the patient, length of application, the peculiarities of patients, references to the Weir |