Actinomycosis of the Orbit.

Paul Muller (abst. in Zentralblatt fur Chirurgie 2, 1911) gives a resume of our knowledge of this rare affection with an account of a case from the clinic of Burns. The patient was a 33 year old woman, who complained of difficulty in opening her mouth with exophthalmus and diminution of sight. In order to get at the orbit better, a temporary rescetion of the zygomatic process was made, and the diseased tissue cleared out. This produced considerable improvement both in the general condition and of the vision, but eventually the disease made its way to the brain and caused death. Of the 9 cases collected from literature, all but one died of an extension to the brain. The most striking symptoms are exophthalmus with diminished motility of the eye-ball and reduced sight. A positive diagnosis can of course only be made by the detection of the germ. Only when the operation is done at an early stage, is there much chance of success. In the majority of cases, the germ seems to have reached the orbit through the temporal fossa and the interior orbital fissure. Gifford (Omaha).

A Comparison of Hospital Facilities.

Inquiries from leading physicians in the following cities concerning the number of available hospital beds, have given the following report:

St. Paul...... with a population of 214,000 has 1120 beds. Kansas City.. with a population of 248,000 has 1240 beds. Denver... with a population of 213,000 has 910 beds. Omaha. with a population of 124,000 has 1430 beds. Minneapolis.. with a population of 301,000 has 1230 beds. This information demonstrates what the writer has long believed, namely, that Omaha has not only a large medical and surgical territory, but that we lead in hospital facilities for the care of these cases.

Veratrum Viride in Eclampsia.

Fabris has found this drug so useful that he regards it almost as the specific remedy. He relates the details of five cases in which it was used, and reviews seven articles in Italian literature, confirming its value in this disease. The pulse grows slow, the blood pressure and temperature drop, while peristalsis is induced, diuresis favored and albuminuria subsides. The patients all tolerated it without disturbances.

A. B. Somers, (Omaha).

Practical Points in the Management of Poliomyelitis

and its Sequelae.

Henry Ling Taylor, New York, N. Y. (Medical Record, October 15, 1910), thinks that time is wasted in treating anterior poliomyelitis with massage and electricity. These agents have little effect. The prevention of deformities and their correction is of the utmost importance. But rest in bed should be maintained for a long time in order to prevent stretching of the affected muscles by the weight of the paralyzed limbs. Many cases of scoliosis in young adults have been traced to an early attack of poliomyelitis. The abdominal muscles are often affected and contribute to the scoliosis. It has been shown that an extensive small celled infiltration surrounds the vessels of the infected area; that the cord is edematous; that the motor cells atrophy secondarily; that the pia of the spine, bulb, and base of the brain is involved, even in cases showing no meningeal, bulbar, or cerebral symptoms. There are many quickly fatal cases as well as cases without paralysis. The author has notes of cases showing aphonia, dysphagia, ocular and facial paralysis and temporary paralysis of the bladder and rectum. Apathy and moderate stiffness of the head are common. Abdominal paralysis is quite common. As soon as the acute symptoms have subsided measures should be undertaken not to allow of stretching of the paralyzed muscles by the weight of the limbs. Support should be fitted. After deformity has taken place it is important to correct it by apparatus and operations. There is no advantage in exercising the opposing muscles, but quite the reverse. Improvement may be obtained even in cases of long standing by these measures, and a fair amount of motion obtained by careful balancing of the muscles.

Atropin in Gastric Ulcer.

Schick (Wien, klin. Wochenschr., 1910, No. 34).

In gastric ulcer, the resultant pylorospasm and hypersecretion are due to vagus irritation. The latter can be eliminated by means of the systematic administration of atropine and this explains the favorable results obtained by the use of this drug in such cases. Schick advises the daily hypodermic injection of one milligram of atropine for two weeks. The subjective symptoms, especially the pain, disappear promptly. The hyperacidity and the hypersecretion are more obstinate but with persistence in the treatment may also be made to vanish. He also obtained

good results with this treatment in spastic constipation, lead colic, membranous enteritis and various forms of intestinal obstruction. He even finds this treatment worth a trial in gallstone and renal colic.

Our own experience with atropin in gastric ulcer is not so favorable. The symptoms can unquestionably be relieved thereby, but the ulcer seems to persist since the production of occult blood persists and relapses are the rule. Two courses alone promise permanent results: prolonged rest in bed with bland diet or surgical interference.

Cause and Effect.

There is a type of newspaper journalism which causes the thinking to grieve and the decent to shudder; it has neither conscience nor honor; it glorifies indecency and envelops immorality with sickly sentimentality and a maudlin moralizing; its advertising pages are open to anything that will go through the United States mails-and to many things that would not, if they were brought to the attention of the authorities. The habitat of such papers is confined t ono locality; they are to be found, in most of the large cities of this country. While what follows deals only with a California example, the subject-matter may easily fit any other of the same type.

A correspondent on the Pacific Coast recently sent to The Journal a clipping from a San Francisco paper of this kind, in which appeared the most shameless and openly worded abortion. advertisements. One of these described how a "Dr. F. E. Grant" at 1293 Golden Gate avenue was prepared to:

Guarateed to cure the longest and most obstinate female cases in 24 hours by strictly up-to-date, antiseptic, safe and painless methods without delay from home or work."

"Travelers can be treated and return home the same day. We have never had a failure. Confinements and adoptions

arranged."

And more of the same tenor. This, it should be remembered, was but one of many similar advertisements. These filthy, criminal and wicked notices are what this San Francisco paper serves up to its readers for the money there is in it. They constitute a cause; the effect follows.

San Francisco, within the past two weeks, has been shocked by the details of a crime which bids fair to outdo in grewsome

details the Crippen tragedy. According to the reports, a young school teacher who had loved not wisely but too well found herself pregnant and went to San Francisco to be relieved of the consequences of her indiscretion. She sees the Grant advertisement boldly offering to perform the criminal act she desires and she places herself in his hands. While on the operating table she expires and Grant, the police claim, to hide the consequences of his crime, dismembers the body, packs it in a trunk and, renting a house for a short time, buries the body (saturated with nitric acid) in the cellar. After a few months had elapsed -during which time the Grant advertisement and others similar to it continued to outrage decency-the crime is discovered and the San Francisco public is served with the details of the tragedy. Note what happens: The very paper, which by every moral law is, at least indirectly, responsible for the poor girl's death and is an accessory before the fact to the crime which has been committed, comes out with "scare heads," doubleleaded type, and all the "yellow" accessories which go with this type of journalism. Page after page is devoted to the gory details of the crime--more than half a page being given to a picture of the murdered girl.

In the abortionists' column of the same issue of the paper in which these sickening particulars are printed, Dr. Grant's advertisement is missing, but the others-thirteen of them-are there. In the editorial columns, also of this issue, the editor thunders virtuously against those "who make their money by catering to depraved tastes and have no scruples against corrupting the young!"

How much longer will the American people permit the pages of the daily press to be thus prostituted and debauched? The trade of criminal abortion is vile enough at any time even when carried on in secret and hidden from the public gaze. When, however, this villainous traffic is exploited brazenly and openly through the columns of the daily press it is time for the decent element of society to take a hand, if only to protect the integrity of the social fabric itself.-Editorial in J. A. M. A.

Auto-Observation of an Auto-Operation for Hernia, Under Strychnine-Stovaine, Spinal Anaesthesia.

M. Alexandre Fzaicou of Jassy, Roumania, chief of the second surgical clinic of Prof. Juvara, describes in the "Presse Medicale" for February 11th, 1911, the bizzare experience of operating upon himself, after his chief had injected into his spinal canal a solution of strychnine and stovaine.

The operator describes in great detail his sensations accompanying the insertion of the needle and the onset of anesthesia, which, supplemented by hypodermic injections at the field of operation, was sufficiently profound at the end of twenty-six minutes to permit of the making of the initial incision.

Through the various steps of the operation no pain was experienced excepting at the extreme upper end of the skin incision. A modified Bassini was done.

During the operation Mr. Fzaicou experienced a vertigo upon executing a quick movement, but the intellectual faculties rested intact and the consciousness was perfect, as proof of which he carried out to completion a delicate auto-operation.

The young surgeon maintained throughout the injection and operation the sitting posture, thus confining the anesthesia to the lower part of the body.

His convalescence is minutely described, marked chiefly by insomnia, headache and epigastric pain. In twelve days he was out of bed.

S. R. HOPKINS, Hastings, Nebr.

Chloroform in the Treatment of Eclampsia.

The usual plan at the Sloane Maternity, New York, is to deliver as soon as possible, consistent with the mother's soft parts, after the occurrence of the first convulsion, if not before.

No further use of chloroform, as commonly used in the treatment of eclampsia, is for the control of the convulsions. Since March 15, 1909, there have been at the Sloane Maternity 12 cases of eclampsia in a series of 1,261 confinements. Any patient showing any symptoms of toxemia, no matter how slight, has been treated without chloroform. Ward feels that by this method they have undoubtedly cut down the number of patients showing actual convulsions, i. e., eclampsia. In these 1,261 women Ward has used no chloroform whatever in toxemia or eclamptic cases except in two patients early in the series. Neither of these patients was very toxic, as these cases go, and only small amounts were used for delivery. There have been no maternal deaths. A small series such as this means little, and similar results have been obtained under the chloroform treatment in a larger series of cases. Ether has been used for actual delivery or for any manipulations when an anesthetic has been required. These patients take ether as well as chloroform, and there is no