he always secured a basin by his side. After taking a mouthful or two of fluid, he began to cough and vomit and spit, the contents of the basin being partly vomited food, partly dirty pus with a very offensive smell, and often an intimate admixture of blood with the pus. He was quite ready to take his food, but seemed to vomit up, in the process of swallowing it, about one half of what he took. The cough likewise occurred apart from the taking of food. In view of the post-mortem examination this condition became quite intelligible, although very puzzling during life. DR. NEWMAN showed MICROSCOPIC SECTIONS OF THE MYOMA OF THE UTERUS shown at last meeting by Dr. Renton. MEDICAL ITEMS. UNDER THE DIRECTION OF ALEX. NAPIER, M.D. Prolapse of Rectum treated by Hypodermic Injections of Ergotine.-Dr. Jette writes favourably of Vidal's treatment of this affection. He says that Bonjean's or Yvon's ergotine only should be used. The former may be employed diluted to a sixth of its usual strength with cherry-laurel water, 15 drops representing 80 ctgr. of ergot, which is about the dose which it is prudent to commence with. The injection must be made as near as possible to the part which it is desired to influence, the needle being introduced about 5 millimetres from the anal orifice, parallel to the intestinal wall, and should be pushed in to the depth of 2 to 4 ctm., that is, into the fibres of the sphincter. The injection should be made slowly, to avoid causing pain, which is always considerable. The treatment may last from a few days to several weeks; and to protect against relapse 3 or 4 supplementary injections should be made after apparent cure. M. Jette's success in using this method of treatment has been invariable, and in those of his cases seen eight or ten months after there was no relapse.-(Thèse de Paris, 1882.) Bull. Gén. de Thérap. 28th February, 1883. Phenoresorcine.-M. F. Reverdin offers this as a new antiseptic which possesses many advantages over most others. He prepares it by mixing 67 parts of carbolic acid with 33 of resorcine. This yields a product which crystallizes slowly. 10 per cent of water added to it dissolves it and keeps it fluid; and this mixes with water in all proportions—one respect in which this combination is superior to simple carbolic acid.-Journal de Thérap. 10th March, 1883. Mixed Anæsthesia.-M. P. Aubert, after referring favourably to the use of morphia hypodermically as an adjuvant to chloroform inhalation, writes even more highly of morphia and ether similarly used; but his best results in mixed anæsthesia are obtained from the combined use of morphia, atropia, and ether. The morphia renders the action of the anæsthetic more rapid, and permits the induction of unconsciousness with a smaller dose; while the atropine diminishes the excitability of the pneumo-gastric nerve, and thus gives almost absolute security against sudden arrest of the heart's action. The solution employed by Aubert is the following:10 centig. 4 milligr. Hydrochlorate of Morphia, 10 gram. Of this he injects about a gramme and a half, that is, 12-15 milligrammes (about grain) of morphia and 6-7 tenths of a milligramme (about grain) of atropine. This is injected twenty-five to thirty minutes before administering the ether. Anæsthesia results in three to seven minutes; the ether is well borne, and gives rise to none of the signs of the usual stage of excitation; there is no vomiting during anæsthesia; the return to consciousness is easy and calm. Those who have practised this method of mixed anesthesia have been struck with the difference between it and ordinary anæsthesia with ether, the former silent and quiet, the latter attended generally by initial excitement, ready vomiting, and disturbed awakening. The great superiority of ether over chloroform lies in its well known harmlessness; its defects are, that it is more disagreeable to patients, and produces insensibility more slowly. But as the preliminary injection of morphia and atropine renders the action of ether as rapid and as pleasant as that of chloroform, why not always use ether in this way?-Lyon Méd. 14th January, 1883. A Victim's Account of Cinchonism.-Dr. Kempf (Indiana) gives the following account:-"I once suffered an attack of acute tonsillitis, and to prevent suppuration I concluded to cinchonise myself thoroughly. When I took the first dose of 10 grains of quinine, my temperature was 104° F. One hour afterwards I was restless, could not sleep, and a peculiar condition of the nerves of my body, causing trembling, was noticed. These symptoms were probably due to cerebral congestion. I now took another dose of 10 grains in capsules, and lay on a bed with my head buried in the pillow, waiting for further developments. I was acutely awake, and sensitive in the highest degree. A scissors fell on the floor in the next room, and I imagined that it fell on my body point foremost, causing an electric shock. Gradually a sense of fulness in the head came on, accompanied by a feeling as if a band tied round my head was slowly being tightened. Then, away in the distance I heard something which reminded me of the March winds approaching. Louder and louder they grew, and nearer and nearer they came. All at once they struck the house as if they were going to turn it topsy-turvy. I raised my head to take a last look at the wall, but a sense of giddiness and vertigo overcame me, and I sank back. Presently the door opened, and a kind voice asked something, and I yelled back at the voice to talk louder, as I was almost deaf. A louder voice asks-'Do you want something?' 'I want to be let alone,' I answered back, and tried to gulp down my angry feelings, but the swelled tonsils gave me a warning not to try it again. I was in about as miserable a fix as I could wish for. My temperature was 102° F. three hours after the second dose, pulse about 80, and an intense headache slowly approaching threatened to make things dreadful. A vomiting spell capped the climax, and after two hours of intense wretchedness, I fell into a sleep, made restless by terrorising dreams. The sequels were a diarrhoea accompanied by griping pains, and a feeling in my head for a day or two as if its contents were trying to escape. I had been thoroughly cinchonised."-Louisville Medical Herald. May, 1882.-G. S. M. Rheumatic Edema and Supra-clavicular Pseudolipoma.-Prof. Potain, along with M. Verneuil, has described a singular affection, which he has called pseudo-lipoma of the supra-clavicular region, and which appears to be connected with the rheumatic diathesis. Ovoid and triangular, this swelling is contained within the borders of the supra-clavicular fossa; it is ill defined to the eye and to the hand; it is elastic, and does not retain the impression of the fingers. This affection is not painful, and may last for several years without giving any trouble. No surgical operation is required, but it is very interesting from a diagnostic point of view. All the patients of M. Verneuil, as also those of M. Potain, were rheumatic. In the majority there was tumefaction, chronic and painful, of one or more articulations. The urine presented a marked tendency to the formation of gravel. But in one patient M. Potain determined the complete absence of signs of rheumatism or gout. The pseudo-lipoma is always connected with chronic rheumatic affections; among M. Potain's cases two were diabetic, and one had atheromatous dilatation of the aorta. A good number of the cases suffered from abnormal irritability of the nervous system. Dampness did not seem to take any part in the etiology. In all cases in which M. Potain was able to determine hereditary antecedents, it was on the maternal side. The etiology of the affection would be complete if one could discover under what influence the pseudo-lipoma is produced. This affection sometimes extends beyond the region which has been assigned to it, invading the adjacent and other parts of the body. Often one finds, in individuals attacked with chronic rheumatism, a tumefaction of the supra-clavicular region, and of the back of the hand. The hand is almost always an arthritic one, especially in females. In several cases the pseudo-lipoma became considerably enlarged and troublesome in cold, damp seasons. A certain number of the patients have, at the same time," some oedema of the subcutaneous cellular tissue. M. Potain observed this eight times in his twenty cases. One cannot separate the supra-clavicular pseudo-lipoma from this mobile oedema, between which there are all gradations. One must admit in these cases a serous infiltration, in spite of the difference in consistency. This oedema of the arthritic is not, moreover, an isolated fact; without the pseudo-lipoma oedema is often found in the rheumatic without other cause than the rheumatic diathesis. M. Kirmison, in a memoir inspired by M. Gayon, and M. Davaine have noted acute temporary ademas found in the course of rheumatism. Three conditions may contribute to give rise to this oedema-the action of damp cold, disturbance of the nervous system, and some local affections which may provoke an acute, sympathetic edema. A temporary edema may then show itself in the course of acute or chronic rheumatism.-La France Médicale. 19th October, 1882.-G. S. M. Absorption of Sequestra. From experiments, in which pieces of dead bone and of ivory were inserted into the medullary cavity of the tibia of rabbits, M. Lannelongue has come to the following conclusions: 1. That the absorption of sequestra is a fact which has been experimentally demonstrated. 2. That suppuration in the cavity holding the sequestrum is an obstacle to absorption. 3. That absorption of dead bone takes place more rapidly and easily than of ivory; besides, it is followed by the formation of new bone. 4. That bone employed for this purpose must be carefully disinfected.-La France Médicale. 20th May, 1882.-G. S. M. Primitive Laryngeal Cancer. The Lyon Médical for 19th November last, contains a review of an essay on the Symptomatology of Primitive Cancer of the Larynx by L. Desprez. By primitive cancer he means that which originates in the vocal cords, and which may afterwards extend to the epiglottis and arytenoid cartilages. Since the publication of the thesis of Blanc in 1872, he points out that many cases have been recorded, and he estimates the number as being over one hundred and fifty, the principal observers being Ziemssen, Faurel, Krishaber, Koch, Descants, and Morolle. Cancer of the larynx is rare in females, because they possess other organs more predisposed to it. M. Desprez agrees with Krishaber that there is no diathesis, and that the majority of the sufferers are robust, and have no family tendency toward the disease. The two principal types are epithelioma and encephaloid. In the encephaloid form hæmorrhage frequently occurs, the tumour being very vascular, and appearing first as a little bud. In the epithelioma, on the contrary, the disease steadily involves the tissues. He advocates tracheotomy, but makes no mention of total extirpation of the larynx.-J. A. A. Sudden Death during Labour.-Dr. G. Heinricius, of Helsingfors, relates the particulars of a sudden death during labour. The patient was a washerwoman, 38 years of age, in sound health so far as known, and with her third child. She walked into the hospital in the afternoon, and on examination was found in labour, a first cranial position, os uteri dilating, and pains strong. Within an hour after her admission she suddenly became convulsed, and died in a second or two. She was immediately seen by the doctor, and within five minutes after the death of the mother the child was brought away by |