On the Nature of what is called Sciatica. — The following is the gist of a clinical lecture delivered by Mr. Jonathan Hutchinson on the above subject:-"I believe that in nineteen cases out of twenty in which the diagnosis of 'sciatica' is suggested, there is no affection of the sciatic nerve whatever. They are simply cases of arthritic disease of the hip in one or other of its various forms-acute gout, chronic gout, rheumatic gout, subacute rheumatism, or chronic senile rheumatism. Both by the public and by the profession these cases are constantly called 'sciatica.' Our workhouse infirmaries are full of chronic cases under that name, and I speak advisedly when I say that I feel sure that they are almost all examples of morbus coxæ senilis. Of the cases of sciatica which are not hip-joint rheumatism, some are probably affections of the fascia or of the periosteum near the hip; a minority are possibly affections of the sciatic nerve itself. In these latter it is the sheath of the nerve that becomes painful. The pain may be darting or may radiate, but it does not pass down the nerve-tubules or in any way make the patient conscious of their course. The diagnosis of true sciatica is to be based upon the discovery of tenderness restricted to the trunk of the nerve, and involving a considerable part of its course. Examples of this are decidedly rare, and their recognition without risk of error is a matter of great difficulty. -Med. Times and Gazette. 28th January, 1882.—G. S. M.

Rectal Examination in Hip Joint Disease.-M. Cazin, in the Rev. de Chir. for 1882, advocates rectal examination as an aid to diagnosis in hip joint disease. He first points out the difficulty of ascertaining the exact seat of the disease, and of determining how far the acetabulum is involved. The coxo-femoral articulation, on account of its depth, is little accessible to examination, and from this fact rectal exploration is the readiest way to approach it. On the internal surface of the pelvis, immediately above and a little behind the obturator foramen, a smooth osseous surface is met with, almost quadrilateral in shape. This surface corresponds to the border of the acetabulum, and may be designated the postacetabular surface. The inner portion of the cavity in an adult is very thin and sometimes transparent. In the child below fourteen years of age it is occupied by cartilage.

The symptoms found on rectal touch are localised pain, revealed by pressure on the post-cotyloid surface; the presence of engorgement of the intra-pelvic glands; increase in the size of the component parts of the acetabulum; destruction and

perforation of the post-cotyloid surface; swelling of the soft parts, and pelvic abscesses of various sizes.-New York Medical Journal. November, 1882.-J. A. A.

On the Therapeutic Value of the Seeds of Euphorbia Lathyris (L).—In a note to the Académie des Sciences, MM. Sudour and Caraven-Cachin record the cure of a case of poisoning by these seeds in a child, nine years of age, by astringents and opiates, and the results of some experiments they were induced to make upon themselves.

1. The principle contained in the seeds of euphorbia lathyris belongs to the class of drastic purgatives. It is unequally distributed among various seeds, some being poor in the active principle and others rich.

2. Vomiting almost always precedes the purgative action, even when the substance has been taken in a small dose. The action may be manifested in forty-five minutes; but it may be retarded for three hours.

3. The seeds produce an irritant effect on the mucous membrane of the digestive passages; their action principally bears on the large intestine, and on the pharynx in the form of pain when mastication has been prolonged.

4. In a large dose this substance produces poisonous effects, which may be divided into three periods: (1) algid (vomiting, diarrhoea); (2) period of excitement (nervous phenomena, vertigo, delirium); (3) period of reaction (heat, abundant sweat).

5. Opiates are the most prompt and effective remedies.

6. The doses prescribed in various works on botanical medicine (6 to 12 seeds) are excessive; in this dose the seeds may give rise to extremely grave gastro-intestinal irritation. Being very active, and its dose difficult to determine, this substance should not be employed in medicine.-La France Médicale. 18th October, 1881.-G. S. M.

Chloral in Diphtheria.-Korn in the Deuts. Med. Wochen., strongly advocates the use of a solution of chloral in glycerine for cases of diphtheria, the strength varying from 15 to 30 per cent according to the age of the child. An evident caustic and antiseptic effect is produced upon the mucous membrane of the fauces. Very often the pain is relieved and the difficulty in swallowing diminished. The natural colour rapidly returns, and even the severe cases will be immensely relieved in three or four days by this simple application.-J. A. A.

The Medical Student.-This is how he is described by the editor of the Boston Med. and Surg. Journal, 12th October, 1882:

'He has come to town in his usual exuberance of numbers and spirits. Somebody (we believe it is Charles Reade) makes one of his female characters speak of a young man who has disgraced himself by 'consorting with medical students and other like abominations.' It must be confessed that this lady has only given utterance to what is quite a general sentiment regarding this unfortunate being. He is not apt to be an ornamental member of society. His dissecting room experiences constitute a large portion of his conversational stock-in-trade, and he has the bad taste to introduce them on all sorts of occasions; and the chances are that he horrifies the neighbourhood by leaving a parcel of bones on the roof, to be found by an enterprising policeman, and to furnish a brief draught of scandal for the thirsty reporters.

All this, and perhaps more, must be admitted regarding the medical student, yet, notwithstanding, he is a good fellow. He is an honest, hard worker, and he feels the satisfaction (unknown to many a less uncouth young man) of mental growth. He is no dilettante. He runs about all day to lectures, and hospitals, and dispensaries, and then generally gives a solid evening to his books. He gets much satisfaction out of very vile tobacco, and is usually contented with the amount of alcohol to be found in beer. Even on the few occasions when he does take recreation, he is apt to patronise that form of the drama which gives him the best opportunity to review his anatomy. He has no very high notions of art, but he does attend pretty faithfully to what he is here for. He is noisy, but good natured, and will lend a dollar (if he has it) to his companion to-day, with a cheerful alacrity second only to that with which he will borrow the same amount of somebody else to-morrow."

From all this it is evident that there is a strong family likeness between the medical student of this country and his cousin" across the pond."

GLASGOW

THE

MEDICAL JOURNAL.

No. II. FEBRUARY, 1883.

ORIGINAL ARTICLES.

ADDRESS ON THE TREATMENT OF PULMONARY CONSUMPTION, DELIVERED AT THE GLASGOW PATHOLOGICAL AND CLINICAL SOCIETY, 14TH NOVEMBER, 1882.

BY DR. M'CALL ANDERSON,

Professor of Clinical Medicine, University of Glasgow ;
President of the Society.

GENTLEMEN,-The treatment of a disease which, year by year, carries off a considerable portion of the population of these islands, and which seems to take a special delight in seeking out for its victims those who are in the very springtime of life, and who are eagerly pressing forward towards the goal of their ambition, cannot fail to be of the deepest interest to us. And as every year brings in its train novel views with regard to its pathology and treatment, it seems well that we should from time to time review our position as to its management, and consult together as to the best methods to be pursued.

In introducing this subject we must be content with stating in a very general way the views which we are at present inclined to accept, in the hope that at some time during the session the subject may be discussed, and the opinions of the members of the Society fully elicited.

In the first place, then, we must make sure of our diagnosis: this is often an easy matter indeed, but sometimes we may, for a while at least, be in doubt whether we have before us a case of phthisis, or some other disease such as enteric fever, No. 2.

G

Vol. XIX.