her husband, her brother, and the nurse, held her, while I opened a vein in the arm. As the blood flowed, at first scattered generally around the room and on the persons of those of us about her, she gradually became more quiet, sank down on the bed, and fell into a sound sleep while I was bandaging the arm. Nearly five hours after she awoke, at once asked for her baby to be put to the breast, and she was perfectly cured. After this she did not have a single symptom of disease, and her convalescence was rapid. We estimated the quantity of blood taken at about fifty ounces, although so much was lost at first that we could not judge very accurately. In no case have I ever seen the effects of medical treatment so promptly and so happily curative." John P. ART. III. THE AMERICAN PRACTITIONER. D. W. YANDELL, 1870. The two volumes of this journal for 1870 have been received from the publishers. These are bound with rare taste and elegance, and are equal to the best specimens received from New York and Philadelphia Houses. The typography of these volumes is most creditable to the publishers, and is in every respect acceptable and beautiful. It is a source of great pleasure to see that a Louisville House is able to compete in method, elegance, and efficiency, with the best Houses in this country. As specimens of typography and mechanical manipulation, these volumes cannot be surpassed. ART. IV.-FIRST MEDICAL AND SURGICAL REPORT OF THE BOSTON CITY HOSPITAL. Edited by J. NELSON BORLAND, Physician; DAVID W. CHEEVER, Surgeon. 8vo., pp. 688. Boston: Little, Brown & Co. 1870. V. Treatment of Skin Diseases-By Howard F. Damon.There is given in this paper the number of cases of skin affections applying for treatment, along with two lithographic illus trations and one chromo-lithograph, beautifully representing a typical case of urticaria annulata. Though the descriptions of the cases are excellent, contrary to what we would suppose by the heading of the article, the writer has gone through the entire article, saying least of all about the treatment of his cases. Typhoid and Typhus Fever-By J. Baxter Upham.—We have here tabulated in extenso the histories of 152 cases of typhoid fever and 38 of typhus fever. We have recorded in a tabular form the frequency with which the various symptoms of the two forms of fever present themselves with a minuteness which we do not recollect to have seen equaled. It would seem by these tables that in Boston the old popular name for typhoid fever, viz: "winter fever," is not at all applicable, since we learn that there were admitted into hospital in spring 27 cases, 35 in summer, 74 in autumn, and only 16 in winter. The three early symptoms most commonly present in the 152 cases of typhoid fever were, chills in 94 instances; headaches, 112; anorexia, 68; the three symptoms most frequently found in the later stages were, rose-spots 109 times; tenderness, 97; tympanitis, 64. Quite contrary to what is taught in the books, constipation was observed in as many as 66 cases. We remember years ago hearing Dr. Austin Flint, in a lecture upon typhoid fever, dwell upon the extreme rarity of a death in the affection when the patient was constipated, and our observations since have all been confirmatory of the statement; but it seems that in the Boston City Hospital it was present in 3 of the 21 fatal cases. The treatment was not materially different from the ordinary expectant and sustaining course pretty generally in vogue with the profession, we believe, throughout the world. The average duration of the disease, dating from the first marked symptoms of the fever, to the period when the temperature and pulse had sunk to nearly the natural standard, and there was a craving for solid food, was 34 days. The mortality, as shown above, was 1 death in 7 cases. The average duration of the typhus fever cases, estimating their beginning and ending by the same plan adopted for those of typhoid fever, is more plainly defined generally in the former than the latter affection, for, as the writer says, "The onset of the disease was mostly sudden and severe; the approach of convaleseance was well marked, and heralded by a decided relief and subsidence of the symptoms. It was sometimes accompanied with profuse diaphoresis;" the average duration was 18 days. Of the 38 cases 10 died, showing in round numbers the large ratio of 1 death in 3 cases. The treatment, while essentially sustaining, did not embrace the routine stimulant plan. The paper is illustrated by thermographic tracings of typical cases of recovery and death from each affection. VIII. Reproduction of the Tibia-By David W. Cheever.This is an interesting account of a case in which Dr. Cheever removed the entire diaphysis and lower epiphysis of the tibia, with subsequent reproduction of the bone, a useful limb resulting. Since Ollier, in his great work de la regeneration des os, has only collected five cases. Dr. Cheever thinks that such renewals are rare, and appends to his article extracts from all five of them at length. In the practice of the late Dr. Thompson F. Craig, of Danville, Ky., we, some years ago, saw almost a precise counterpart of the case which Dr. Cheever has detailed. IX. Ophthalmic Report-By Henry W. Williams.—This is a table and brief report by Dr. Williams of the cases, operations, and their results in the ophthalmic department. Dr. Williams has modified the ordinary operation for cataract by the insertion of a very fine suture at the centre of the wound in cases of flap extraction. Though we believe the method of Dr. Williams has been before the profession for some years, and in his exceedingly dexterous hands has been very successful, yet, if we mistake not, it has met with but little favor in the eyes of ophthalmologists generally. X. Report of the Aural Department-By J. Orm Green. The number of patients reported upon by Dr. Green is not large (158), the report covering only four months and a half, however, since the opening of the department. Among the cases of acute simple inflammation of the tympana, is one of much interest. A girl aged sixteen, who had been very deaf for years, "requiring a very loud voice within a few feet," entered the hospital with typhus fever, and for some days lost her hearing entrely. "Both membranes were swollen, deeply injected along the manubria, and immovable; the eustachian tubes closed, the throat inflamed. The inflammation was reduced, and the airdouche, by Politzer's method, used for some three weeks, at the end of which time she had not only regained the degree of hearing, which she had before the fever, but had improved so much that she could hear a distinct voice twenty feet distant, and she herself announced that she heard better than she ever remembered to have heard." Dr. Green explains the improvement by supposing that the acute inflammation caused a resorption of old deposits or thickening of the tympanum. XI. Two Cases-By David W. Cheever.-1st. Encephaloid Tumor of Tonsil.; 2d. Occlusion of the Vagina.-The first case is related because of the rarity of cancer of the tonsil, and the great size of this "as large as a pullet's egg,"—and the necessity for its removal by a deep dissection from the outerside of the neck down parallel with the sternocleido-mastoid muscle. The last case was one in which death followed the attempt to make a vagina in a case of congenital absence of the organ. On dissecting up to what was supposed to be the os and body of the uterus, and making an incision to complete the communication with the newly-made vagina, no body of uterus was found, but the peritoneum was entered, and two oval bodies, supposed at the time to be ovaries, but afterwards proven to be the two separated cornua of a malformed uterus, were reached. The patient died of peritonitis. XII. Peri-Uterine Inflammation-By A. D. Sinclair.-This paper is a relation in detail of twenty-odd cases of pelvic affec tions, including intra-pelvic phlegmonous abscess, pelvic cellulitis, pelvi-peritonitis, and peri-uterine inflammation. The paper, occupying some sixty pages of the volume, is of interest for its simple, detailed history of each of the cases, some of which recovered, and some proved fatal, there being nothing especially new observed in any of the phenomena of their progress, or adopted in their treatment. XIII. Surgical Abstract-By David W. Cheever.-1st. Aneurism; 2d. Ligature of Vessels; 3d. Cases of Cut Throat; 4th. Tracheotomy; 5th. Foreign Bodies in the Esophagus; 6th. Perineal Section; 7th. Lithotomy; 8th. Radical Cure of Hernia; 9th. Strangulated Hernia; 10th. Fractures; 11th. Fractures of Spine; 12th. Compound Fractures; 13th. Amputations. The article on aneurism gives an account of those cases of popliteal aneurism operated on, one dying, and an aneurism of the innominate, in which an unsuccessful attempt was made to tie the carotid and subclavian arteries, a failure to succeed being the result in each instance. The first cut over the carotid was followed by such a welling up of such an "inky stream" of venous blood that feeling alone was to be depended upon, and the finger failing to detect pulsation, the attempt to ligate the carotid was abandoned. The spine difficulties followed the attempt to ligate the subclavian, and in the attempt to pass the needle, the subclavian vein being wounded, a section of the middle-third of the clavicle was made, and a portion, an inch and a half long, by means of Hay's saw, was removed. The welling out of the blood "of the color of prune-juice" continued to obscure everything, the depression and dyspnoea continued to increase, and the patient appearing moribund; further attempts were abandoned, the wound plugged, and the patient died within two hours. One of the popliteal cases was successfully treated by flexion, another, ninety-nine hours of flexion failing, was cured by acupressure of the femoral. Acupressure of the femoral was used in the third case, and with the cessation of pulsation in |