General Cotton spoke of the great use of the tree in India, and the Bishop of Edinburgh referred to the success which had attended its planting in South Africa. LONGEVITY. ing up marshes, and in tending to the salubrity of an literature-Dyspareunia—which means pain in congress. unhealthy district. Chapter vii. speaks of the significance of leucorrhoea. Chapters ix., x., xi., and xii. treat of watery, gaseous, and bloody discharges, and pain. Chapters xiii. and xiv. treat of pain in congress and sterility. Chapters xv. and xvi. treat of the instruments required for diagnosis, and the way to use them. Chapters xvii. to xxiii. treat of diseases of the ovaries. Chapter xxxiv. of diseases of the Fallopian tubes. Chapter xxxv. of diseases of the broad ligaments. Chapter xxxvi. of extrauterine gestation. From chapter xxxvii. to chapter xl. the diseases of the uterus are spoken of. Chapters xli, and xlii. speak of perimetritis and pelvic hæmatocele. Chapters xliii, to xlvi. are dedicated to displacements. Chapters xlvii. and xlviii. speak of fibrous tumours and polypus; chapter xlix. of tubercle; chapter 1. of cancer; chapter li. of diseases of the vagina; and chapter lii. of diseases of the vulva. Sir Duncan Gibb, M.D., L.L.D., then read a paper upon "Longevity at Five Score Eleven Years." He said he had brought forward nine examples at previous meetings of the association of persons who had overstepped the century by several years, and now his tenth instance was that of a female still living at Tring, in Hertfordshire, who attained her hundred and eleventh birthday in April last. Tables were quoted containing 84 instances of persons whose age extended from 107 to 175; 40 of these were under 130, and 44 above that age, and the author considered that three-fourths of the total number might be taken as correct. The proof of that was the instance he brought forward of Mrs. Elizabeth Leatherland, now alive and in her 111th year, her baptism being recorded in the register of the parish of Dover, in Kent. This was confirmed by the drowning of her son and his family, and other persons to the number of 37, at Hadlow, in Kent, in 1853, in the hop country, by a catastrophe mentioned and described in the papers of the time. Her son was then fifty-nine, and if now alive would have been eighty, his birth occurring when his mother was twentynine or thirty. Other corroborative circumstances were stated, clearly establishing the great age of the old dame, who was of gipsy descent. The author then described her condition, the result of a careful personal examination at Tring in October, 1873. She walked with the aid of a stick, was short in stature, bent with age, complexion brownish, countenance a series of thick folds, and she had several sound teeth. She chatted away continually in a clear, distinct voice, and was in possession of all her faculties, though somewhat impaired. She was a little deaf, and took snuff; her skin was as soft as velvet, and her hair quite grey. She was thin, and the muscles of her neck stood out in bold relief. All her internal organs were in perfect health, lungs, heart, &c., and her pulse was as regular and as soft as in a girl of eighteen. In fact, the changes of old age as met with in persons from seventy to eighty had not taken place in any of the tissues of the body, being thus similar to the nine other cases examined by the author. She was, of course, feeble; but, taking all things together, that did not prevent her reaching to her present exceptionally great age. Her age, the author said, taught us two lessons -one was the absence of senile changes for the most part in centenarians, which was the chief reason of their attaining to such a great age; the other the occurrence now and then of instances wherein even six score years is reached, if not more. To ignore all past cases of extreme ultra-centenarian longevity because we cannot get at their proofs at the present day he considered unphilosophical and unscientific, for there existed as conscientious and painstaking inquirers after truth then as exist now, whose statements and recorded facts must not be wholly ignored, as every honest investigator well knows. ABOUT BOOKS. Clinical History of the Medical and Surgical Diseases of Women. By ROBERT BARNES, M.D., F.R.C.P. London. 1873. THE work is divided into fifty-two chapters, some of the earlier of which are occupied in descriptive anatomy of the ovaries, Fallopian tubes, uterus, and vagina. Chapter vi. treats of the conditions indicating the necessity for examination, and the author introduces a new word into medical "The division of leucorrhoea," says Dr. Barnes, "into uterine, vaginal, and vulvar, as propounded by Donné and Tyler Smith, is based not less on clinical than on anatomical foundation We frequently find associated with leucorrhoea patches of the surface of the vaginal portion of the cervix denuded of epithelium-small ulcerations they may be called a state of tumefaction, even redness. Are these caused by the leucorrhoea? In the majority of cases they assuredly are not . . . Dr. Tyler Smith submitted that sometimes the discharge possessed acrid or irritating properties capable of directly inducing ulcerations, granulations, follicular cysts, and other disorders—that is, he looked upon leucorrhoea as a primary disease. This opinion seems to me to want confirmation." His treatment of leucorrhoea is general and local. "We must not too harshly assume that the treatment of strumous or syphilitic leucorrhoea resolves itself into the constitutional treatment of the struma or the syphilis." Solutions of acetate of lead, sulphate of zinc, alum, oak-bark, and tannin are praised, and for topical use to the interior of the uterus sulphate of zinc, nitrate of silver, alum, and iodine. Strychnine, quinine, and arsenic are used as tonics in fit cases. In the treatment of hæmorrhages Dr. Barnes recommends, when no remediable cause is discoverable, plugging the vagina. Clots of blood are first removed by the hand, and the vagina washed out with cold water. It is preferable to plug by aid of a speculum, and pieces of lint may be used, or linen and silk handkerchiefs. In a few hours these may be removed, and the uterus may then in certain cases be dilated with a tent, or incised at its external mouth. In passive hæmorrhages ergot, digitalis, cinchona, turpentine, ipecacuanha, acetate of lead, tannin, alum, and dilute sulphuric acid are praised. In his chapter on pain the author speaks of vaginismus and mentions the cases where there may be observed a dark red angry-looking ring of inflammation around the orifice, sometimes even abrasions or slight fissures, which easily bleed on being washed. There is intolerable hyperæsthesia. In such cases Dr. Barnes recommends two or three incisions to be made through the skin on either side of the fourchette, and excision of any remains of the hymen or caruncula with stating that he never uses the knife in such cases, but employs the scissors, in the form of a ring. Scanzoni is cited as rest, lotions, and dilatation; but Barnes has found these inadequate in some cases. In treating of sterility six causes are given. By far the most common associated conditions with sterility, in his experience, are congenital narrowing of the os externum and retroflexion of the uterus. These conditions are frequently combined, and are commonly attended by dysmenorrhœa. Dysmenorrhoea is often presumptive of sterility. "So preponderating is the association of a minute os externum and retroflexion, separately or combined, that in any given case of a woman who remains sterile five years after marriage and suffers from dysmenorrhoea, it may be predicated with almost certainty that one or other of these conditions exists." He relates the case of two sisters with small os externum and retroflexion, both married and sterile. In both Dr. Barnes divided the external os and corrected the retroflexion by a Hodge pessary, and both became pregnant. He is inclined to doubt that sterility in the male is so rare as it is represented. In crypt-orchids there are no spermatozooids. Chapter xv., treating of the bag of the gynecologist, is very graphic, but rather alarming, from the number of instruments mentioned. Fergusson's speculum and Henry Bennet's are praised, as also Cusco's. Kuchenmeister's metrotome scissors are employed by the author, with a slight modification of his own. He approves of Weiss's wire écraseur for polypus, and speaks well of the sponge-tent carrier, and of Higginson's vaginal syringe, with a four-inch vaginal tube. "The influence of protracted amenorrhoea," says Barnes, "upon the nervous system is always prejudicial, and sometimes deplorable, and is very liable to merge into pulmonary consumption. The treatment of acute amenorrhoea, if resulting from cold, requires warm baths, turpentine, enemata, and sudorifics. When chronic, iodide of potassium, iron, strychnine, and suitable hygiene are required." In cases of imperforate hymen the author makes a very small opening in the membrane, and lets the fluid gradually drain away. But death has followed all kinds of treatment. if modern practitioners do not like bleeding. Issues in the neck are also advised. The chapters on ovarian dropsy and other diseases of the ovary are, as might be expected, written in a masterly manner, and the latest statistics are given. The chapters, too, on pelvic peritonitis and hæmatocele are admirable, and should be studied by all. Among the best chapters in the work are those which treat of prolapse, retroversion, retroflexion, anteversion, and anteflexion. The plates in these chapters are most graphic. The treatment of prolapse and hypertrophy of the uterus is sometimes heroic enough, and the author occasionally seems to practise amputation of the cervix uteri. In all cases of procedentia the bladder should be periodically emptied, and the uterus should, if possible, be replaced and kept up by a a pessary of some kind or other. It is one of the many controverted points in diseases of women whether the use of pessaries in prolapse is or is not a scientific proceeding. "If pessaries are found useful," says Dr. Barnes, "it matters little whether they satisfy the requirements of science. That thousands of women do find comfort and benefit from their use is a fact too notorious to be disputed. I add my testimony to that of Dr. West, Dr. McLentick, and many others, who have seen not only comfort, but cure result from pessaries." The operations performed for prolapse are uncertain and not free from danger. There are six kinds of pessaries described, and Hodge's pessary seems to be the greatest favourite with Dr. Barnes. Zwancke's pessary is not free from danger. Local astringents may be used as adjuvants. When the Hodge fails the stem-and-cup pessary is useful. When this instrument is in situ the vaginal portion of the cervix rests in the cup and the narrow stem is grasped by the vagina. When the power of the vagina is insufficient to grasp the stem its retention is aided by external elastic bands carried up in front and behind, and attached to an abdominal belt. The elastic bands, yielding at each inspiration, permit the natural ascent and descent of the uterus, and obviate the concussion and violence which rigid external supports would cause. The pessaries should be of vulcanite. "Before the use of Hodge's and Zwancke's pessaries the use of external supports was more general than it is now. Hull's utero-abdominal supporter is the best known; and one The chapter on dysmenorrhoea is very full, and perhaps the most valuable in the book. The author disagrees with those who insist on the frequency of stricture of the os internum. Dilatation by tents, &c., is not satisfactory. In a few days the canal has contracted to its old dimensions after dilatation, and numerous accidents, such as septicemia and cellulitis, follow the use of sponge-tents, and even laminaria tents. Dr. Barnes does not like double metrotomes, but uses scissors. The patient keeps her bed for four days or a week, and immediately after the operation it is generally useful to insert a Wright's stem pessary. Success is greater if the patients are young. Barnes agrees that the cure of sterility is not nearly so frequent as the cure of dysmenorrhea; but in a consider-known as Ashburner's pad is good. Each of these tightly able number of cases conception does follow. An objection urged by the advocates of dilatation against incision is that they frequently contract again; but then it should be again had recourse to. Barnes uses a speculum, a uterine sound, metrotome scissors, and a Sim's tenaculum hook for this operation. He does not use chloroform, as the operation is rarely very painful. The sound is introduced to ascertain the direction of the cavity of the cervix. The speculum is introduced, and the plain blade of the scissors is passed into the cervix from half an inch to an inch, the part intervening between the blades being divided by a sharp stroke. Thus, only the vaginal cervix is divided. It is enough to give a good transverse slit, or os tincæ. Bleeding generally stops in a few minutes; if not, a small piece of lint dipped in perchloride of iron may be introduced. Dr. Barnes next treats of ovarian and membranaceous dysmenorrhoea. "In the male sex," says Barnes, there is no epochal limitation of sexual life. There is nothing to compare with the almost sudden decay of the organs of reproduction which marks the middle age of women." He is sanguine, or sanguinary enough to advise in cases of disease at the menopause, accompanied with plethora, abstraction of eight or ten ounces of blood from the arm; but compounds for some leeches embraces the hips. Hull's is furnished with a large padded When treating of anteflexion, anteversion, retroversion, and retroflection, Dr. Barnes gives the usual rules for diagnosis of these very common malpositions of the uterus. His treatment is almost entirely that of Hodge, and with the exception of recommending the elastic horse-shoe pessary of Professor Thomas in anteversion, there is not much novelty. In his chapter on cancer of the uterus Dr. Barnes praises the use of bromine, as recommended by Drs. Routh and Williams, and recommends amputation of the cervix in some cases. The work is thoroughly up to the day in all that relates to the very important speciality of the diseases of women. It should, we think, be perused by all physicians, in case they make errors in diagnosis from not knowing the symptoms to be expected in diseases of the generative organs in women. Perhaps in some future edition Dr. Barnes may have time to reduce the size of the work to more moderate dimensions. Great books are great evils, because, alas! there is so much to be read. Annual Report of the Supervising Surgeon of the Marine Hospital Service of the United States. 1873. THIS is a handsome volume, illustrated by photographs and several plans of hospitals. The report contains much valuable matter, a carefully prepared table of the diseases admitted into the different marine hospitals, a chart of yellow fever in the United States, giving elevations above sea-level of localities where yellow fever has appeared since 1668, and various important papers on medicine and surgery. Clinical Medicine: Lectures and Essays. By BALTHAZAR FOSTER, M.D. London: J. and A Churchill. 1874. DR. FOSTER'S name is so well known to the profession that any lengthened notice of the work before us will, we opine, be unnecessary. The lectures which compose the work have already appeared in various medical journals. A larger experience and more lengthened study of the subjects treated have, however, enabled the author to make many additions to the original articles. We need hardly say that they are one and all really valuable contributions to clinical medicine. His advice has been of service and acted upon by a large number of physicians, not only in this country, but abroad—for instance, the lecture "On the Use of Ether with Cod-liver Oil in the Treatment of Phthisis," which is now generally recognised and prescribed; again, "Digitalis and Heart Disease." "The Synthesis of Acute Rheumatism," and his observations "On Diabetes and its Treatment," are most valuable. The rare disease known as "Duchenne's paralysis" is carefully treated of. Rather than give extracts from the work before us, we advise our readers to purchase it for themselves, and we affirm that they will not be disappointed. Sulphur in Iceland. NOTES, NEWS, AND GOSSIP. THE DANGER OF USING SHOT FOR CLEANING FORDOS has recently directed attention to the dangers of lead poisoning where shot are used for cleaning bottles that are to be used for wine and other beverages. When shot are placed in a glass with water, carbonate of lead is at once formed, a portion of it being noticed as a precipitate in the water, while another portion of it attaches itself as a thin film to the sides of the vessel. This film adheres so firmly to the glass that it cannot be removed by rinsing with water alone, an acid being required to remove it. When shot are used for cleaning bottles which are afterwards well rinsed out, the carbonate of lead suspended in the water will be removed, but that portion which is attached to the sides of the bottle remains, and is afterward dissolved by the liquid placed in the bottle, if it possesses a sufficient solvent power. If the shot are only shaken up with water for a short time, it is scarcely possible for the carbonate of lead to become attached to the sides of the bottles, but oftentimes the shot are left in the bottle with the water for some time. Besides, the rinsing is not always done as carefully as it should be, and the carbonate of lead suspended in the water is not all removed. Fordos took four half-pint medicine glasses that had been cleaned with shot, and in one he placed white wine, in another red wine, in the third quinine wine, and in the fourth vinegar. After standing two days each was found to contain a considerable quantity of lead. Another danger might also arise from shot getting lodged in the narrow creases at the bottom of certain bottles, when the action of an acid upon it would dissolve not only the lead but also the arsenic which is always present in shot in sufficient quantity to render the liquids poisonous.-Druggists' Journal, April, 1874. OBITUARY. ATKINSON.-On the 1st August, Robert Atkinson, L.S.A.L., House CARLILL. On the 22nd July, at Weymouth Street, Portland Place, John DURHAM.-On the 4th August, at Sandford, co. Dublin, Andrew FERGUSON. On the 6th August, at Prospect, Mullingar, Joseph Fer- HAYMAN.-On the 2nd August, at West Malling, Charles C. Hayman, HOWATT.-On the 16th July, H. R. Howatt, M.D., of Cumberland MARTINDALE.-On the 21st July, John Walker Martindale, M.R.C.S.E., MAULE. On the 9th August, at Bath, John Templeman Maule, M.D., late Deputy Inspector-General of Hospitals, Madras Army, aged 73. By C. CARTER BLAKE, Doct. Sci. NORTON.-On the 1st August, at Nantglas, Llanelly, Carmarthenshire, London: E. and F. N. Spon. 1874. DR. CARTER BLAKE is well known as an anthropologist. In the pamphlet before us he gives many interesting facts regarding sulphur. The pamphlet is illustrated by several maps. It well repays perusal. IN THE LABORATORY. MEANS OF DISCOVERING WHETHER RED WINES M. DE CHERVILLE, in Le Temps, gives the following useful hints for deciding the above :-"Pour into a glass a small quantity of the liquid which you wish to test, and dissolve a bit of potash in it. If no sediment forms, and if the wine assumes a greenish hue, it has not been artificially coloured; if a violet sediment forms, the wine has been coloured with elder or mulberries; if the sediment is red, it has been coloured with beetroot or Pernambuco wood; if violet-red, with logwood; if yellow, with phytolac' berries; if violetblue, with privet berries; and if pale violet, with sunflower." John Howard Norton, M.D., aged 59. RIX. On the 17th June, on board the Royal Mail Steamship Nile, SANDWITH.-On the 25th July, at Todwick Rectory, Sheffield, Humphry SCHLESINGER.-On the 29th July, B. M. M. Schlesinger, M.R.C.S.E., TRAILL. On the 21st July, at Stromness, Orkney, William Traill, WATKINS.-On the 27th July, John Watkins, F.R.C.S.E., of Thatcham, TO ADVERTISERS. THE increasing circulation of the DOCTOR makes it a valuable mediam for all announcements intended to reach the Medical Profession. We have, however, only a limited space at our disposal. Advertisers themselves are the best judges as to whether it is best to have their announcements in a journal where they are not buried in a large number, and lie on the table a month instead of a week. To secure special position, advertisements should be sent early. Advertisements may be sent to either of the Publishers, or direct to the office. The Scale of Charges for Advertisements is as follows:- One quarter page ................. 1 2 6 250 Orders, Advertisements, and Business letters to be addressed to the Publishers. NOTICES. THE DOCTOR is published Monthly, price Sixpence, and sold by all booksellers. It is also supplied by the Publishers named at the foot of the last page. Subscribers paying in advance receive the DOCTOR post free at the published price. Subscription may begin at any time, but must end in December. This is necessary on account of the multitude of small accounts. Post-office orders or cheques to be made payable to Baillière, Tindall, and Cox, 20 King William street, Strand, London, W.C. Where it is difficult to obtain a Post-office order, postage stamps (HALF-PENNY ones preferred) may be sent. No form of subscription is necessary; an ordinary visiting card or name and address on paper, enclosed with the amount of subscription, will secure the regular transmission of the DOCTOR as soon as published. The Subscription for the year, is 68., post Free in the United Kingdom. In America, France, Belgium, Algiers, Australia, and wherever the postage is one penny the subscription is 7s. ; India, Spain, Germany, and where the postage is twopence the subscription is 8s.; Italy, and where the postage is threepence, 98. CHRONICLE. DR. SEE ON BELLADONNA AND NICOTINE. DR. SEE, in a lecture at the Hôpital de la Charité, says that atropine is the most complete antagonist of muscarine, that cardiac medicine spoken of by O. Schmiedeberg in 1869. Six or seven years ago, Meuriot, one of Dr. Sée's pupils, noticed that atropine caused acceleration of the movement of the heart. The ganglia which terminate the atropine are successively employed, we notice that the If muscarine and pneumogastric nerve are paralysed. heart, arrested by the effect of the muscarine, begins to palpitate with atropine; but muscarine cannot arrest the palpitations of an atropised heart. The paralysing action of atropine on the pneumogastric is, then, very energetic. Atropia has besides the power of exerting the blood-vessels and making them contract rhythmically. To this commencing contraction of the vessels let us add the most remarkable effect of this drug, the dilatation of the pupil, which takes place from contraction of the dilating muscle, excited by the sympathetic. There is also paralysis of the sphincters, of the pharynx and larynx, and of the voluntary THE DOCTOR. DOCTOR. muscles, with impaired sensibility. LONDON, OCTOBER 1, 1874. Multum in parvo. THE NORWICH MEETING. We have had almost a surfeit of congresses and meetings, from the science one of Great Britain, reported in our last, to that of France, held at Lille. Nicotine is the neutral principle of tobacco, and is a vascular poison above all, but also a cardiac poison. If a small dose of nicotine be injected into an animal, we notice first a retardation of the heart's action, and next, augmented pressure in the vessels. If the animal be opened, the vessels are found contracted. There is, in a word, enlargement of the vaso-motor nerves, and of the vessels, and also tetanic rigidity. When there is a strong dose of nicotine, we notice the inverse: the heart's action the vessels, depending on fatigue of the muscles of the is notably increased, and there is complete relaxation of vessels; the heart's action becomes accelerated, because then nicotine acts like atropine, by paralysing some part of the suspending system. Ordinary smokers have palpitations, or slow pulse sometimes, 48 pulses per minute, with with rapid pulse, 130, 140, 150 pulsations per minute. intermittences; extravagant smokers speak of palpitations Roux, an old professor of the Faculté de Médecine, years ago. Muscarine, when injected, will lower the pulsaconsidered that smokers were "gredins;" but that was forty tions caused by nicotine. The medical meeting at Norwich, though not nearly so impressive as the really brilliant medical section at Lille, got through a good deal of work in the sections. We furnish this month some selections from these. It is the less to be regretted that we have not space for a complete account of the papers read, inasmuch as they will appear during the ensuing year in the Journal of the Association. We feel, however, that it is a pity so many of them will be so long delayed. Far better, abstracts ought at once to be published in the Journal of the Association, and slips should be sent to the other It is a poor papers. apology for the want of journalistic courtesy to say they may be had by asking for. We should like, too, to see all other matters relating to the Association made (b) Medicaments which paralyse the muscles; type- (c) Medicaments which paralyse the muscles of the heart; (e) Medicaments-motors of the spinal marrow; types—~ strychnine, morphine. (f) Anæsthetic medicaments. 2. Trophic medicaments. A sub-class: distrophic medicaments. 3. Medicaments acting on the emunctories; examplesdiuretics, diaphoretics, purgatives. more public, so that the profession might judge of the worth of its work. To compete with the other weeklies ought not to be the main object of a journal established for the sake of recording the proceedings of a great medical association. If this object were kept in view, lectures, reports, and other non-asso4. Medicaments which modify the system by their thermic, ciation matter to say nothing of puff paragraphs-chemical, and physical properties; such as hydrotherapy, would not be allowed to crowd out for months toderivatives, electricity. gether the papers read by members. We demand. that our own material should have the preference in our own journal. CHLOROFORM DURING SLEEP. DR. W. R. CLUNESS reports in the Pacific Medical and Surgical Journal two cases in which chloroform was administered and anæsthesia produced during sleep. One case was that of a girl of eight years, and the other a girl two and a half years of age. In each case a surgical operation was performed. Neither of the patients offered the least resistance or showed any signs of consciousness in passing under the influence of the choloroform. SWALLOWING A TOOL-CHEST. Ir is reported that in the different prisons of Paris there are five or six deaths every year from the effect of swallowwhat is known as an escape-box." This remarkable box is made for the special accommodation of prisoners. It is of polished steel, about three inches long, and contains turnscrews, hammers, silk thread, and other implements necessary for escape. The box appears to be easily swallowed, but sometimes fails to reappear as intended, and the death of the victim is the result. But, when it does pass the bowels, the lucky prisoner is prepared to cut the thickest iron bars and set himself at liberty. CROUP. WHAT are diseases which can still simulate croup ? Dr. H. Roger, of Paris, gives the following reply to this question. 1. (Edema of the larynx; but it is exceedingly rare amongst children, and by the examination of the superior part of the arytenio-epiglottic folds all doubt is removed. 2. The introduction of foreign bodies, such as a cherrystone, a bean, &c.; but there is no fever; besides, recollection comes in aid, as well as the other signs of which we have spoken. 3. Retro-pharyngeal abscess, which gives rise to these symptoms-cough, fever, difficulty of respiration, suffocation; but the examination of the throat suffices to put an end to all idea of croup. water bottles. Subsequently the strongest extract of meat was given to him. It Another case was that of a gentleman's servant, with hemorrhage arising from the gum between a first and second molar of the upper jaw without apparent cause. had resisted for hours the application of astringents and escharotics. The first molar being defective, was removed, and its alveolus plugged with matico and lint, after which no further bleeding occurred. The plug should always be allowed to come away of its own accord; and in cases where all local means prove unavailing, Mr. Coleman strongly advises ligature of the external carotid, instead of the easier operation of tying the common carotid artery. INJECTIONS INTO THE VEINS. La France Médicale reports the following conclusions of Professor Robin from a new series of experiments :1. The injection of water into the jugular vein in doses equal to one-thirtieth or one-fiftieth the weight of the body, will kill a rabbit. 2. When the injection is made in the external saphenous vein, it will be necessary to inject as much as onetenth. 3. Injections of water either in the peritoneum or the veins, equal to one-eighth the weight of the body, will not kill dogs; at one fifth, death is by hæmorrhagic rupture; but the phenomena of uræmia have not been observed in any of the animals that died during these experiments. 4. Water injected into the blood, as Richardson had already observed, acts on the red globules, of which it injures the structure, and probably renders them unfit for the gaseous changes which ought to go on in them. The idea that death is caused by an affection of the nervous system cannot be admitted, on account of the absence of encephalic lesions. 5. Death probably comes, in the case of animals subjected to injections in the jugular vein, by the difficulty of respiration, due to the abrupt and continued arrival in the HÆMORRHAGE OCCURRING AFTER DENTAL pulmonary system of blood charged with too great a pro OPERATIONS. In a clinical lecture delivered at the Dental Hospital Mr. Alfred Coleman described some troublesome cases of hæniorhage treated by himself. The first was one in which it became necessary, after the extraction of a lower molar, to open an alveolar abscess which had formed. For this purpose a "Paget's knife" was used. There was moderate bleeding, but no pus evacuated, although the knife passed into a softened mass. Two days afterwards the swelling had considerably increased, and threatened to burst. A fine probe was therefore passed into the feebly united incision it slid into a place from which, on removing it, arterial blood spurted out per saltem. The bleeding was considerable, and it became evident that in making the incision the facial artery, or one of its largest branches had been wounded, and that consequently a traumatic aneurism had formed. A very troublesome case was anticipated, but after a time the bleeding quite ceased. The next case mentioned was one of secondary hæmorrhage, occurring in a boy fourteen years of age, from whom a lower molar tooth had been removed on the previous day. He woke up in the middle of the night with his mouth full of blood, and the bed and clothes completely saturated. When seen he was lying on his back, blanched, cold, almost pulseless, restless and delirious, and complaining that he could not see. It was quite evident that he had lost a very large quantity of blood. Without altering his position, large pieces of coagula were removed from his mouth, and the aveoli where the tooth had been removed thoroughly cleared out, and a pellet of matico-leaf, previously softened in water, firmly inserted into each. Lint was then placed over these, a little brandy administered, and the jaws brought firmly together. He was permitted the access of plenty of fresh air, but was made warm in bed with hot portion of water. 6. If we reflect that in twenty-four hours a dog only excretes 22 c.c., 5 of urine for every kilogramme of his weight, and that in these experiments injections have been made equal to 100, 125 centimetres cubes of water per kilogramme, we understand how difficult it is can to admit as the pathogeny of uræmia the increase of the intra-vascular pressure under the influence of the suppression of urine bringing on oedema and anæmia of the brain. 7. Traube's doctrine, then, judged by these facts, does not appear to be the true expression of the physiologicapathological phenomena. SUBLINGUAL TUMOURS. THE Boston Med. and Surg. Journal reports the case of a sublingual tumour of ten years' growth, in a woman aged twenty-five. It increased in size until eating and speaking were almost impossible. It presented a uniformly smooth surface, except where deeply adherent, was elastic and fluctuating; the tongue was pushed up to the palate, and could not be seen when the mouth was opened. An incision was made over the tumour, and the lateral adhesions broken down with a director; it was then dissected from its deep attachments, which extended nearly to the hyoid bone, and partial division of the genio-hyo-glossus was necessary before its removal could be effected. The growth was as large as a duck's egg, encysted, evidently congenital, and contained sebaceous material rolled into small balls. In the same journal we find a similar case of sublingual tumour, in a man, seventy-three years old; of gradual growth; unaccompanied with pain; one year's duration; the size of an English walnut; situated under the tongue; |