ease.

dren of the house suffering from the same disDr. Cassel believes that, in most cases, the gonorrhoea was not spread by sexual connection, but by common use of beds, baths, wash-rags, sponges, etc. Gonorrhoeal pus is, in contradistinction to that of the non-specific disease, a thick, creamy, greenish-yellow fluid, which commonly erodes the vulva and inner side of the thighs. While at the onset of the disease the pus is almost a pure culture of the gonococcus, it contains, toward the end, numerous other micro-organisms with but a few gonococci. Complications, gonorrhoeal conjunctivitis was twice observed, and in one case had a favorable termination. The course of the affection was very slow, being prolonged, on an average, for two or three months, and some cases continued for a half or three-fourths of a year. The six cases of non-gonorrhœal origin exhibited no peculiarity. In some the discharge was tenacious, grayish-white, and scanty; in others, a grayish-yellow and thin pus was observed. Two cases were the relics of a gonorrhoea of the previous year.

Others were the result of propagation of suppuration from surrounding parts to the vulva. Finally, a form was seen in newborn babes which should be attributed to severe catarrh of the desquamative genital mucous membrane. SPASMODIC RETENTION OF URINE.-Excessive irritability is ("N. Y. Med. Jour.") one type of interference of the higher centres; the other form is spasmodic retention. Thus, when a man wishes to pass water, he is anxious, especially if some one else is standing by and waiting, as in a public urinal, to make water in a hurry; the desire to make water quickly prevents him from passing it at all. This form can frequently be relieved by some such plan as that adopted by Boerhaave. He lived before taps were so common as now, and he used to have a screen in his consulting room behind which was placed a tall footman. When he desired any of his patients to pass water, the footman, at a given signal from him, poured water from a water-bottle into a basin on the floor, so as to imitate the sound of a person passing water, and this at once had the desired effect. If, in the out-patients' department you want to get a specimen of water quickly, in order to examine it, the best thing you can do is to turn on a tap, and if that is not sufficient leave the patient to himself and tell him that there is no hurry whatever; as a rule, if there is more than two teaspoonfuls of water in the

bladder, you are sure to get it by this plan. Sometimes also, when there is no water running, if the patient only thinks of the sound of running water, it will make the bladder act. The introduction into the urinals at railway stations of constantly running water has been of great service to many. Some passengers can now empty their bladder at a railway station who could not have done it before, although it does not occur to them that the constant running of water has anything to do with the evacuation of the bladder; it has, however, a great deal to do with it. Washing the hands with cold water is another help, as also the application of a cold wet sponge or hot water to the perineum; and making the patient sit down in a hot sitz-bath will frequently enable him to pass water into the bath when he could not do it otherwise.

GENERAL MEDICINE.

ANGINA PECTORIS.-Dr. Lanceraux attributes ("Med. Week") certain cases of this neurosis to aortic inflammation involving cardiac plexus lesion. A 34 year-old woman suffered from intermittent fever since she was 8 years old. When he saw her she had for several years had spasmodic attacks of suffocation and oppression, which for two years past had alternated with severe paroxysms of angina pectoris, beginning at the epigastrium and extending not only to the upper portion of the thorax, but also to the left arm and forearm, and frequently even to the middle of the lower jaw. These paroxysms, which lasted from ten minutes to a quarter of an hour, sometimes ended in a copious sialorrhoea and frequent micturition. The patient having suddenly died in one of the attacks a post-mortem examination revealed the thickening of the various coats of the thoracic aorta and manifest lesions of the cardiac plexus, the filaments of which were enveloped in the thick external coat of the aorta. It was "aortitis in patches" directly dependent on malaria. These patches involved the entrance of the coronary arteries, thus supporting the view that angina pectoris is due generally to a pathological condition of the coronary arteries. In some cases the coronary arteries were not involved and he does not believe that involvement of these arteries is one of the leading causes of angina pectoris, and he wishes particularly to have it understood that angina pectoris is usually due to aortitis which is patchy and due to malaria, and not caused by what is generally called atheroma.

MISSISSIPPI VALLEY MEDICAL ASSOCIATION.

[To the Editor:] The twentieth annual meeting of the Mississippi Valley Medical Associa tion will occur in Hot Springs, Ark, November 20, 21, 22, and 23, 1894. The association is now in a more prosperous condition than ever before, and no efforts will be spared to make the meeting at Hot Springs not only the largest but the most interesting and profitable ever held. Indeed, its success is already assured, many valuable papers by most excellent authors having been promised. Hot Springs is an ideal place of meeting, and November in that charming southern health resort is the most delightful month of the year. Socially, the visit will be enjoyable in the extreme, as the physicians and citizens with their characteristic hospitality are united and enthusiastic in their endeavors to make the sojourn of their guests pleasant. The railroad rates will be very low, and will be announced later.

FREDERICK C. WOODBURN, M. D.,
Secretary.

INDIANAPOLIS, IND.

"PAINS IN AMPUTATED LIMBS."-Dr. Witzel explodes a popular and even a medical superstition anent the feeling by old soldiers, sailors, etc., of pains in toes lost by amputation. He claims ("Med. News") that neuralgia after amputation is not caused, as is generally supposed, by the formation of neuromata at the ends of the divided nerves. He states that if such were the case it would be necessary to lay aside the amputating knife. The neuralgic pains, he be-lieves, are due to adhesion of the neuromatous swelling to the end of a bone. In order that its functions may be properly performed a nerve should move freely in its sheath. The structural elements which serve the special function of a nerve are during life extremely delicate and almost fluid. The ordinary movements, therefore, of an adjacent joint would interfere with the structure and functions of the nerves of a limb if these nerves had no longer free range of movement in the direction of their long axes. In two cases of neuralgia after amputation in which Witzel had opportunities of dissecting the stumps he found thick neuromatous swellings at the ends of the divided nerves, which were bound down by tough cicatrical tissues to the

ends of the bones. It is evident that during movements of the stump at the nearest joint the fixed nerves must be stretched, those on the flexion side during extension and those on the extension side during flexion. In neuralgia caused by confinement of a nerve in a mass of callus the pain, it is held, is due to the prevention of the nerve's movement and not to its compression. As a preventive treatment Witzel recommends that in every amputation as much attention should be paid to the nerves as to the large arteries, and that the former should be pulled away from the flaps and divided high up. Attention should be particularly directed to this precaution in cases of amputation at the ankle and shoulder.

THE BICYCLE AND THE FEMALE PELVIC ORGANS.-Dr. T. Ronsing ("Pacific Med. Jour.") agrees with de Pezzer as to the evil effects produced by bicycle riding on the female genitalia. Pressure of the saddle may cause affections of the skin, the anus, muscles, nerves and veins in both sexes; of the vulva in the woman, but more especially of the urethra in the male. Unfavorable conditions for bicycle riding are poorly developed muscles, absence of fat, and great distance between the tuberosities, because in such subjects the sharply formed front part of the saddle wedges the soft parts in between the sides of the saddle and the tuber ischii. The following lesions were observed: Hardness and rigidity of labia majora, with gnawing, pricking pains, frequent urination with redness, swelling, irritation and serous exudation from the vulva. Rupture of varicose veins and severe hæmorrhage from rubbing of saddle; external hæmorrhoids; prolonged erections from pressure on veins, preventing return flow of blood; retention of urine, with tenderness in the perineal regions and prostate gland. Pressure on the nerves has produced prolonged anesthesia in the perineal region and of the sexual organs. Numerous cases of gonorrhoeal urethritis long subsided have returned with all their virulence after a bicycle ride. Periurethral abscess and urethral fistula necessitating urethrotomy have been caused by bicycle riding. Three cases of rupture of the urethra have been observed, two by jumping upon and one by the breaking down of the saddle.

MORROW'S SYSTEM OF GENITO-URINARY DISEASES.-The third volume of this system is devoted to dermatology. The preface thus announces the reasons for existence of the volume:

"In the effort to present a compendious record of the numerous and important additions made to our knowledge of these diseases within recent years, it was found difficult to compress this mass of material within the limits of conveniently sized volumes. In the preparation of Vol. III. this difficulty has been enhanced by the addition to our nosological category of a large number of new diseases. A comparison of the table of contents of this volume with that of the text-books on dermatology of a few years ago will show that no fewer than forty diseases are now recognized as distinct clinical entities which were then unknown or identified with other dermatoses. New and improved methods of investigation have given us a clearer insight into the intricate nature of many morbid states, necessitating the use of new terms to convey a correct conception of the pathological conditions. The extraordinary activity displayed in the field of dermatology has not been simply in the direction of introducing new terms and names of diseases. Recent researches into the etiology and bacteriology of diseases of the skin have resulted in a clearer comprehension of the essential nature of many diseases formerly obscure, and established the pathological unity of certain affections which were previously regarded as wholly unrelated to each other -such, for example, as the various forms of tuberculosis of the skin, the group of seborrhoic diseases, the bulbous affections comprehended under the general term dermatitis herpetiformis, the several diseases now recognized as due to psorospermial infection and classed as psorospermis cutis, etc."

Part I. deals with anatomy, histology, semeiology, ætiology, pathology, and therapeusis. The second part is devoted to the special dermatoses. The volume is excellently illustrated and beautifully printed. The same defects are noticeable that were present in the syphilology, an undue predominance of a New York clique. Despite these defects the book is a credit to American medicine.

REGIS' MENTAL MEDICINE is a most excellent clinical manual devoted to the subject of insanity. It is probably, as the author remarks, the first instance of a work on mental alienation, written by an alienist, translated by an alienist, printed and

*A System of Genito-Urinary Diseases, Syphilology, and Dermatology. Vol. III. By Prince A. Morrow, M. D. Cloth; 8vo.; pp. 976. Price, $6.50. D. Appleton & Co., New York; A. C. McClurg & Co., Chicago.

+Practical Manual of Mental Medicine by Dr. E. Regis. Authorized Translation by Dr. H. M. Bannister. Utica, N. Y.: American Journal of Insanity Press. 1894. $2.

The

bound by the insane. The book opens with a decidedly interesting history of insanity, somewhat defective yet stimulating and suggestive. classification, while open to many objections, as not recognizing certain forms clinically established, is adapted for use in the schools. The chapter on the relation of neurasthenia to the psychoses is one of the best of the book and is well worth the attention of the general practitioner. The discussion of the diathetic insanities is full and of great value in practice. The medico-legal portion is truer to nature and to the spirit of the English common law than most English text-books. The work is excellently translated by Dr. H. M. Bannister of Chicago, and is well printed and bound.

The following ex

BOURGES' DIPHTHERIA.* tract from the preface to this excellent little work will afford a good idea of its scope: "Diphtheria is a contagious disease due to the bacillus discovered by Klebs and studied by Loeffler. The point of infection chosen by this bacillus is almost always a mucous surface, the pharynx or the air-passages preferably (sometimes an excoriated region of the cutaneous surface); here it forms colonies and pullulates, determining the development of a fibrous pseudo-membrane, of which it occupies the superficial stratum. There the microbe remains entrenched, never invading the organism nor entering the circulation. It may, in the same subject, be transplanted to many different points of the mucous or cutaneous surface, but causes only foci of local infection. But though the organism does not become infected in its entirety, it may be poisoned, for the bacillus produces a very active toxine, demonstrated by Roux and Yersin, which is readily diffusible and penetrates the circulation."

FOWLER'S APPENDICITIS is the revised amplification of the author's contributions to the subject in the "Annals of Surgery." Chapter I describes the Anatomy of the Parts Involved; II, The Inflammatory Lesions of the Appendix; III, Acute Appendicitis, Clinical History; IV, Special Types of Appendicitis; V, Complications and Sequestræ; VI, Etiology; VII, Bacteriologic Conditions; VIII, Pathologic Anatomy; IX, Diagnosis; X, Prognosis; XI, Treatment (General); XII, Operative Treatment; XIII, After Treatment. book is a timely contribution and merits purchase and perusal. It is well issued.

The

*Treatise on Diphtheria. By Dr. H. Bourges. Translated by E. P. Hurd, M. D. Physician's Leisure Library, Pp. 195. Detroit. George S. Davis, 1894. W. T. Keener Co. Chicago.

+A Treatise on Appendicitis. By Geo. R. Fowler, M. D.

Cl., pp. 190. Philadelphia: J. B. Lippincott. Company. 1894. Chicago. A. C. McClurg & Co. Price, $2

CALIFORNIA -Dr. E. E. Stone of Marysville has been elected county physician.-San FranciscoDr. T. Cecil committed suicide recently.-The state board has licensed William Burke, Los Angeles; Sherman Davis, San Francisco; John C. Gosnell; Howard Herrington, Santa Clara; John Briggs Latta, San Diego; Nicholas Molitor, San Francisco; Luther D. Scherer, Los Angeles; George H. Steward, Marysville; Samuel Spencer Wallian; Conrad Weil, San Francisco; Joseph Suley Wheeler, Penryn; Chas. H. Whitman, Los Angeles; Harrison Akers Wright, Klamath Falls, Ore.

CONNECTICUT.-There is an agitation in progress against the insane-commitment law.

DAKOTA SOUTH.-Dr. G. H. Shrodes of Aberdeen married Miss C. S. Blasing September 5.

DISTRICT OF COLUMBIA.- Washington-Dr. J. F. Cottrell died September 9.

GEORGIA. Dr. W. S. Lumpkin of Atlanta, sued that city for $10,000 damages, alleging that the injurions fumes from an open sewer had ruined his health. The jury gave him a verdict for $400, which will not be satisfactory to him, but may serve to teach the city authorities to be more careful in their sanitary arrangements.

IDAHO.-Dr. W. C. Maxey has been appointed superintendent of the Caldwell soldiers' home.

ILLINOIS.-Dr. Anna Dwyer has located in Aurora.-Dr. A. Reeser of Moline died September 13. The state board is to enforce the itinerant clause of the medical practice act.-Dr. J. J. Gordon of Cairo died recently after 40 years' practice. The state board has licensed Drs. Anna Dwyer, Aurora; William Bonnar, Chicago Heights; H. A. Seymour, Hillsboro; R. G. Laycock, U. G. Windell, Jose Widner, and J. A. Stevenson, Charles Dake, S. Rosenblum, W. J. Class, J. B. D. Godfrey, F. E. Andre, T. J. Buskley, and A. D. Davidson, of Chicago; J. C. Defries, Melvin; W. C. Stubbs, Lewisburg, Ohio; H. C. Hill, Sweet Water; V. M. Powell, Peoria; H. F. Bruning, J. E. Hetherington, F. M. Kidnig, W. T. Nichols, Chicago; P. M. Vander Berg, Englewood; M. T. Ward, Toulon; Ira C. Young, Palmyra; A. S. Barger, Jonesboro; J. A. Bishop, Mattoon; H. W. Burnard, La Grange; J. E. Gernand, Rossville; Horace Gibson, Sheldon; H. W. Grote, Wheaton; Dudley S. Reynolds, Collinsville; W. C. Rife, Pulaski; S. G. Smith, Reddick; G. C. Stockman, Mason City, Iowa; A. H. Sante, St. Louis, Mo.Dr. A. Green of Shullsburg has removed to Rockford. Dr. H. L. Jenks of Warren has been elected county physician.-Dr. Potts has removed from Winona to Galesburg.-Dr. G. W. Kreider of

Springfield has been sued for malpractice.-Chicago -Drs. M. R. Barker and H. E. Kerch of the County Hospital have been sued for malpractice in oophorectomizing a married woman without her consent.-Dr. B. S. L. Merrill died September II. -Dr. F. B. Todd died September 2 of angina pectoris.-Chicago is blest with a "charm and witch" doctor, "Dr." Wachter, just now under police surveillance, for obtaining money under pretense of placating spirits.-Dr. F. J. Rucavado married Miss A. O'Reilly September 13.-Dr. G. C. Hoyer has been sued for malpractice. The plaintiff alleges that Dr. Hoyer was called in July 10 to attend him for pleurisy and undertook a surgical operation, making a large incision in the lung cavity. He asserts Hoyer inserted two rubber tubes in the aperture, and allowed one of these tubes to slip into the cavity and remain there until it had caused intense pain and had permanently injured his health.-Dr. Garrott of the health department wants legislation enacted whereby constables and others will be prevented from taking furniture from a small-pox infected house before it has been fumigated.

INDIANA.-Dr. W. S. Hargrove of New Salem died recently.-Dr. C. F. Mitchell of South Bend married Miss G. I. Johnson recently.-The state insane-hospitals are badly overcrowded.-Dr. E. F. Wagner of Logansport has removed to Ft. Wayne. -Dr. E. L. Carter of Evansville died recently and Dr. G. W. McConnel September 13.

IOWA.-Dr. C. H. Paige of Ft. Dodge has removed to Frazer.--Dr. J. W. Campbell of Ottumwa died recently.

KANSAS.-Dr. L. P. Paddock of Metawaka died recently. Dr. Surber of Delphos has removed to Independence. -Dr. M. O'Brien of Topeka died recently and Dr. C. E. Martin of Wichita September 12.

LOUISIANA. The governor has appointed to the regular board of medical examiners Drs. T. S. Kennedy, H. S. Cocraim, T Y. Aby, F. J. Kearney and A. T. Baum, appointed on the part of the Louisiana State Medical Society. The homœopathic board, appointed on the part of the Hahneman State Medical Society, includes Drs. E. A. Murphy, C. J. Lopez, C. R. Mayer, Robert A. Bayley and J. W. Belden. Dr. R. W. Walmsley of New Orleans has been appointed a member of the state board of health.

MAINE.-Dr. W. Farrer of Biddeford still practices medicine, on a bicycle, at the age of 98. MARYLAND.-Baltimore-Dr. B. J. Shorb died September 11, and Dr. H. W. Webster, Sr., September 1.

MASSACHUSETTS.-Dr. B. F. Goodwin of Lynn died September 11, and Dr. Davis of Holyoke Sep. tember 4.

MICHIGAN. Dr. J. A. Desjardins of Marquette died September 2.-Detroit-Dr. H. J. Brown died recently.

MINNESOTA.-Dr. C. J. Beise of Mankato has removed to Mapleton.-Dr. F. M. Peironnet of Waverly has been appointed Great Northern R. R. Surgeon. Dr. Habernight has located at Owatonna and Dr. C. J. Fisher at New Prague.-St. PaulDr. R. S. Bole married Miss K. E. Fox September 12.

MISSOURI. Dr. W. H. Hougland of Mexico died September 2, Dr. Ott of Waddington August 27. Dr. E. S. Leach of Marshall married Miss T. Olson September 6.-St. Louis-Dr. L. Ottofy died September 6.-Dr. S. Robertson of Caseyville was recently croninized.—A Nevada man sued Dr. Campbell and wife, and Dr. Goodwin, all three cancer quacks, and the last a woman, for commission for drumming up custom. Judgment was rendered against the quacks, but they had left town.Dr. Lee Dowell has located at Hickory Creek.Dr. C. F. Hersman of St. Louis married Miss A. W. Bates September 6.

NEBRASKA. Dr. M. M. Newbecker has located at 1703 Dodge street, Omaha.

NEW HAMPSHIRE.-Dr. F. A. Hoyt of Manchester died recently.

NEW JERSEY.-Dr. C. H. Dare of Bridgeton died recently.

NEW MEXICO.-The territorial medical board elected the following officers: Dr. G. W. Harrison of Albuquerque, president; Dr. Atkins of Las Vegas, secretary, and Dr. J. Kanter of Albuquerque, treasurer.

NEW YORK.-Dr. J. C. Miles of Williamsville died September 1.-Dr. M. Shaw of New York has located in Middletown.-Dr. Noah Sanborne of Bayonne died September 7, and Dr. O. P. Crane of Akron September 1.-The constitutional convention has abolished the coroner, but provides no substitute. Dr. D. L. Burroughs of Lyons died September 11.-Dr. J. A. West of Geneseo died September 9.-Dr. M. B. Dean has removed from Newark Valley to Whitney's Point.-Dr. C. H. Williamson of Long Island City died September 10.-Dr. S. G. Ellis of Syracuse died September 13, in the 56th year of his practice.-Dr. E. L. Mooney, of Syracuse has been appointed medical examiner C. M. B. A.-Dr. C. H. Curtiss of Dunkirk has removed to Jamestown.-Brooklyn-Dr. Hanburg Smith, who died September 12, in his 84th year, was born in Staffordshire, England, and studied medicine in a London college. He was graduated in 1831, and then went to Stockholm, Sweden, to continue his studies. During the cholera epidemic

there in 1834 he was senior physician of the cholera hospital. He came to the United States in 1847 and went to Cincinnati, where he was afterwards a health inspector and superintendent of the Ohio State Lunatic Asylum. In 1859 he came to this city, and was among the first to introduce hydrotherapy in chronic diseases.-The county medical society and the city health department are at loggerheads, to the credit of the society. -Dr. R. Saquemetto died recently.-New York City-The recent developments in the city insane hospitals show deliberate bad management on the part of all the officials evinced in the epidemics of scurvy.—Dr. L. A. Hallock is still practicing medicine at the age of 92.-Dr. R. Tracy, in a recent sanitary report on the tenement houses of New York, says: "The most salient points, when these records of death by small districts are examined, are the very high death rate among the Italians, or at least in the districts most occupied by Italians, and the very low death rate in districts occupied by Russian and Polish Jews. The low Jewish death rate can only be attributed to the frugality and temperate habits of the race and the great tenacity of life or inherent vigorous vitality which is the result of such habits extending over thousands of years. The Jew is physically "tough" in its best sense, however frail he may look, and inherits these qualities from a long line of ancestors in whom it has been carefully cultivated. The great mortality among the Italians is not so difficult to explain. They seem to be especially subject to phthisis and pneumonia. They come mostly from southern Italy and Sicily, and are unused to a climate as severe and fickle as that of New York. They tend to crowd together for the sake of economy even more than the Jews, and, although on the whole a pretty temperate class, they drink more than the latter. The number of Italians is now so large that the excessive mortality among them produces an appreciable effect upon the general death rate of the city. In 1890 the Federal census reported 39.951 Italians in the city and 54.334 persons born of Italian mothers. It is safe to assume that at present, four years later, there are at least 50,000 Italians in the city. Now the death rate in the districts largely occupied, and some of them almost exclusively occupied, by Italians is about 10 or 12 points higher than the average for the city, i. e., about 33 per 1,000 against 22.75. That is to say, the mortality among the Italians is at least 10 per 1,000 higher than the average, and this would add at least 500 deaths to our annual total. It is thus made evident, without pursuing the subject further, that the death rate of the city is considerably increased by the presence of unacclimatized foreigners in large numbers." Dr. Tracy presents a table showing the effect of residence in certain special localities, where occupants of tenements are exposed to peculiar conditions.