make traction. In a minute or two a finger could reach the child's mouth, then the chin; and soon the collapsed head of the child was in the world, and the delivery was completed. Such was my first case of "perforator and crochet" labor; and under the circumstances a larger experience would not help much. If I had then a pair of long and strong forceps possessing teeth I could have broken the parietal bones, or wrenched them from their places. Bullet forceps, or any of a half-dozen kinds employed in surgery, would have answered the purpose, but I had none of any kind. The nearest approach to forceps in that abode was a pair of tongs. Craniotomy is a bloody business, but when the necessity for it arises the operator should not be punctilious about postponing the work till the child be dead, lest he be charged with shedding innocent blood. The mother's life is at stake, and can probably be saved by mutilating the child, therefore the perforator and crochet should be employed while hope is present. There are two prominent crimes in the world-the one is of omission; the other is of commission. The first is found at the door of the weak, the inexperienced and the cowardly. Too many parturient women fall victims to such. Here is Dr. Periwinkle who has delivered a thousand women, and has the reputation for miles around for being good in "confinement." He boasts of having rarely used instruments; yet if his record could be retraced, it would be found that Mrs. Brown died undelivered, and that Mrs. Jones was a ditto. Two women's lives lost that might have been saved, yet few knew anything about it, and the doctor was not blamed. Mrs. Brown died because the perforator was not used; and Mrs. Jones lost her life because "an arm was down," and her experienced (?) professional attendant did not know enough to turn, and deliver by the feet.” 66 Let the The above sentence is written to enforce a lesson. old and confident practitioner take heed lest he err; and let the young physician study “hard” labors that he may get along well with his own cases, and occasionally snatch a good one from an egotistic old "granny," who thinks he knows it all because Meniere's Disease. BY PROF. JOHN M. SCUDDER, M. D. Among the singular affections which have been studied during the past twenty years, is this, which was described by Dr. Paul Meniere in 1861. In the typical case, the patient, having had a stroke of apoplexy, finds himself with complete or partial deafness in one ear, tinnitus aurium, or ringing in the ears, and a rotary movement toward the affected side. It may continue for weeks, and terminate with a fatal attack of apoplexy; or if slight, it may gradually wear away, so that the patient is moderately comfortable for a long time. I have had but a single case of the typical disease in my practice, and the gentleman is enjoying fair health eight years after the first attack, though very deaf. In this case, the rotation toward the affected side could be antagonized by a continued influence of the will, though very noticeable when this was withdrawn. But as is the case with "Basedow's disease," or "progressive locomotor ataxy," there are nine minor cases to one which could fairly take the name. Tinnitus aurium, with slight deafness and with dizziness or unsteadiness in muscular action, is frequently met with as an expression of disease. Usually there is more or less headache, and the patient speaks of "dizzy headache," or a headache with bewilderment and fear that the muscular system will suddenly become paralyzed. With symptoms of this kind the patient is very uncomfortable, and wants speedy relief if it can be obtained. In many cases, the symptoms are not of dangerous import, but in some the prognosis will be grave. In such case I want to know whether the cerebral symptoms are sympathetic of disease in a distant part, or are the expression of disease of the base of the brain. They may arise from disease of the stomach, disease of the urinary apparatus, or disease of the reproductive apparatus. The gastric lesion may be purely functional-dyspepsia, or chronic gastritis. The symptoms pointing to the disease of stomach are usually so marked that no one can mistake them, and when the diagnosis is made, a right treatment of the gas make traction. In a minute or two a finger could reach the child's mouth, then the chin; and soon the collapsed head of the child was in the world, and the delivery was completed. Such was my first case of "perforator and crochet" labor; and under the circumstances a larger experience would not help much. If I had then a pair of long and strong forceps possessing teeth I could have broken the parietal bones, or wrenched them from their places. Bullet forceps, or any of a half-dozen kinds employed in surgery, would have answered the purpose, but I had none of any kind. The nearest approach to forceps in that abode was a pair of tongs. Craniotomy is a bloody business, but when the necessity for it arises the operator should not be punctilious about postponing the work till the child be dead, lest he be charged with shedding innocent blood. The mother's life is at stake, and can probably be saved by mutilating the child, therefore the perforator and crochet should be employed while hope is present. There are two prominent crimes in the world-the one is of omission; the other is of commission. The first is found at the door of the weak, the inexperienced and the cowardly. Too many parturient women fall victims to such. Here is Dr. Periwinkle who has delivered a thousand women, and has the reputation for miles around for being good in "confinement." He boasts of having rarely used instruments; yet if his record could be retraced, it would be found that Mrs. Brown died undelivered, and that Mrs. Jones was a ditto. Two women's lives lost that might have been saved, yet few knew anything about it, and the doctor was not blamed. Mrs. Brown died because the perforator was not used; and Mrs. Jones lost her life because "an arm was down," and her experienced (?) professional attendant did not know enough to "turn, and deliver by the feet." Let the The above sentence is written to enforce a lesson. old and confident practitioner take heed lest he err; and let the young physician study "hard" labors that he may get along well with his own cases, and occasionally snatch a good one from an egotistic old "granny," who thinks he knows it all because Meniere's Disease. BY PROF. JOHN M. SCUDDER, M. D. Among the singular affections which have been studied during the past twenty years, is this, which was described by Dr. Paul Meniere in 1861. In the typical case, the patient, having had a stroke of apoplexy, finds himself with complete or partial deafness in one ear, tinnitus aurium, or ringing in the ears, and a rotary movement toward the affected side. It may continue for weeks, and terminate with a fatal attack of apoplexy; or if slight, it may gradually wear away, so that the patient is moderately comfortable for a long time. I have had but a single case of the typical disease in my practice, and the gentleman is enjoying fair health eight years after the first attack, though very deaf. In this case, the rotation toward the affected side could be antagonized by a continued influence of the will, though very noticeable when this was withdrawn. But as is the case with "Basedow's disease,” or "progressive locomotor ataxy," there are nine minor cases to one which could fairly take the name. Tinnitus aurium, with slight deafness and with dizziness or unsteadiness in muscular action, is frequently met with as an expression of disease. Usually there is more or less headache, and the patient speaks of "dizzy headache," or a headache with bewilderment and fear that the muscular system will suddenly become paralyzed. With symptoms of this kind the patient is very uncomfortable, and wants speedy relief if it can be obtained. In many cases, the symptoms are not of dangerous import, but in some the prognosis will be grave. In such case I want to know whether the cerebral symptoms are sympathetic of disease in a distant part, or are the expression of disease of the base of the brain. They may arise from disease of the stomach, disease of the urinary apparatus, or disease of the reproductive apparatus. The gastric lesion may be purely functional-dyspepsia, or chronic gastritis. The symptoms pointing to the disease of stomach are usually so marked that no one can mistake them, and when the diagnosis is made, a right treatment of the gas The disease of the kidneys may be either chronic inflammation or albuminuria, or both. In every case that I have seen, the fissured tongue told the story clearly, and was corroborated by an examination of the urine. The disease of the reproductive function may be either the result of excess or continence-in either case of debility with undue excitation. They are very singular cases and give the physician much trouble. I recall one of a widow, diagnosed as softening of the brain, in which the patient had difficulty in sleeping on account of noises in the ears, and could with difficulty co-ordinate the muscles so as to cross the room. The symptoms had continued for a year, yet were cured by appropriate treatment and matrimony. In the minor cases I am describing, the disease of the brain is functional, and is usually a wrong of the circulation and sympathetic innervation, but it may be a lesion of nutrition. Though we should like to know the exact character of the lesion in every case, we are more interested in knowing the remedies which will cure. We may study those which influence the brain directly in a group, as we have done in other cases. They are iodide of ammonium, bromide of ammonium, podophyllin, ignatia, rhus, gelseminum, belladonna, ergot, sticta, pulsatilla, cactus, to which the reader may add some others. Iodide of ammonium is indicated by dizziness with headache, and an inability to command the voluntary muscles. Ꭱ iodide of ammonium, 3ss, water, 3iv; a teaspoonful every four hours. Bromide of ammonium is the remedy when the symptoms are distinctly epileptiform. That is, there are brief losses of consciousness, with involuntary movements; in some cases very marked, in others but slight. R bromide of ammonium 3ss. to 3j, water, živ; a teaspoonful every four hours. Bromide of potash will be the remedy when the patient is full-blooded, suffers from venereal excitement, and sleeps badly. Podophyllin is indicated by fullness of the veins. The headache is full, tensive, with unsteadiness of the muscles and |