amination. The experiments which were continued for five months gave no curative results; the nodules re mained of the same size and the disease was not in fluenced locally or otherwise.

a leakage, as it were, or to a too rapid escape of blood from the penis when erected. I, therefore, determined to ligate a couple of the larger subcutaneous veins at the base of the penis and watch the effect.

Α

This was very easily done by the use of cocaine. Treatment of Loss of Sexual Power by vein on each side of the penis was exposed, ligated in Ligation of Veins.-Alfred King, M. D., writes in two places and severed between the ligatures. A dressthe Boston Med. and Surg. Journal: The loss of sexing was lightly applied and held in position by a strip ual power, or rather deficient erections of the penis, of adhesive plaster placed longitudinally. The result render so many men miserable mentally and physically, was immediate. In less than five minutes after leaving that any new method of treatment promising a radical cure merits investigation and trial.

my office he had an erection. That night he was awakened by a powerful erection which made the bandage so painfully tight that he was obliged to jump out of bed onto the cold floor to subdue it. Primary union was prevented by the frequent erections, but the success of the operation was certain.

Two months later he reported himself well, mentally and physically; his sexual appetite had returned, and since the operation, his power of maintaining erections had been as good as ever.

Three immediate causes of deficient erections may be specified. Destruction of the erector muscles, loss of nerve power, and a change in the circulation. The first of these is so rare and so easily determined that it needs only a passing notice. The second cause, loss of nerve power, seems to me to have received more promi nence than it deserves, as it is the basis on which almost all treatment is founded. While its force in many cases is undisputed, yet the frequent failure of treat ment based upon it leads me to direct attention to the importance of the third cause, that is, a change in the circulation. This change takes place in the veins, espe cially those which do not pass beneath the pubic arch, or are not acted upon by the erector muscles. Repeated engorgement of the penis renders their calibre larger and, consequently, there is a more rapid escape of blood through them. When, therefore, an erection takes experiments one per cent. aqueous solutions were used place, it cannot be maintained on account of the escape of blood through these channels. Thus we have the history of a gradual shortening of the duration of erections, and, finally, scarcely none if any, as these veins grow larger.

The remedy for such a condition, especially when far advanced, is not in the use of drugs, but may be brought about speedily and safely by the ligation of some of the larger of these veins.

Ehrlich's Urine Test for Typhoid Fever.— George M. Beringer (Boston Med and Surg. Journal) has made a series of experiments to discover to what extent various substances are likely to interfere in this reaction; especially those which from internal or exter. nal administration are apt to appear in the urine, or are known to be normal or abnormal constituents. In the

where the solubility would permit, otherwise saturated solutions.

In applying the test, the author used the contact method, and the following modification recommended by Dr. Simon of the Johns Hopkins Hospital: "Solution 1, a saturated solution of sulphanilic acid in five per cent. hydrochloric acid; solution 2, a five per cent. solution of sodium nitrate; forty cubic centimetres of solution 1 is mixed with one cubic centimetre of solu

The following case is given to illustrate this cause tion 2, and an equal amount of urine is added and and its successful treatment:

Mr. M., aged 35, a laborer of powerful physique,came to me about a year ago with the following history: For several years he had been losing the power of maintain ing an erection, during the past year its duration having been so short that sexual intercourse had been rendered impossible. There was a loss of sexual desire and great mental depression. Excessive use or abuse was the cause of this condition.

mixed. One cubic centimetre of ammonia is now care. fully run down the side of the test tube; at the junc tion of the two liquids there will be observed a ring of the characteristic color varying from an eosine rɔse to a deep garnet red."

Neutral liquids, such as alcohol, methyl alcohol, acetone, aldehyde, paraldehyde, ether, chloroform and turpentine were found to have no effect. The mineral acids and their salts, and organic acids such as lactic, oxalic, acetic, tartaric and citric acid and their salts,also gave no reaction. Salicylates and benzoates gave an orange-colored reaction, the line having a distinct green tint.

I gave all possible encouragement to the patient; ad vised total abstinance from sexual intercourse, cold baths (especially to the spine and external genitals); prescribed bromides, cannabis indica, cantharides, damiana, phosphorus and salts containing it; pushed strych The following alkaloids and neutral principles gave nine as far as it could be borne; gave various tonics; also no reaction: quinine, strychnine, cinchonine, cinused electricity; and, in short, tried everything which chonidine, morphine, codeine, cocaine, atropine, caf offered any hope for success, but all to no effect so far feine, salicin, piperine, propylamine and phenactine. as producing any stronger erections was concerned. Upon adding a few drops of a one per cent antipyCareful study of the case convinced me that the im-rine solution to the mixed reagents, there is produced at mediate cause of the trouble was a physical one, due to once the well-known green coloration produced by this

substance with nitrates. The supernatant ammonia as- ris and Mr. J. Jackson Clarke publish notes of a case of sumes a yellow color, separated sharply from the green xanthoma diabeticorum (British Journal of Dermasolution by a brilliant red line.

tology). They consider that there can be no doubt that the affection is fundamentally of the same nature as the other conditions which have been grouped together under the general name of "xanthoma," excluding the xanthoma of Balzer. They sum up as follows certain clinical and anatomical points of difference between xanthoma and xanthoma diabeticorum.

Urea, uric acid, glucose and saccharose were all found to have no effect. Albumen gave an orange to a red line, depending on the amount present; two drops of a one per cent. solution gave a reddish orange reac. tion, which became a distinct red on increasing the amount of albumin. While pepsin gave but a green line, the addition of a very small quantity of peptone 1. While xanthoma (planum and multiplex) is slow in resulted in the production of a distinctly pale red line. evolution, and generally permanent, xanthoma diabetiThe most minute quantities of phenol and creosote gave corum appears suddenly and subsides almost as suda dark red at once, and a single drop of a one per cent. denly. phenol solution gave a reaction identical with that ob2. Xanthoma planum invariably begins on the eyetained from typhoid urine. Sulpho-carbolates of solids, and is usually confined to them; xanthoma muldium and zinc gave a pale eosine red line, gradually tiplex affects chiefly the flexor and extensor surfaces of darkening. Beta napthol gave a brilliant magenta col- the limbs, the eyelids, and the palms; the diabetic or and resorcin a dark reddish brown at once. Thymol variety for the most part attacks the neck, trunk, and and eugenol likewise produced the red line. Gallic extensor surfaces of the limbs. acid and pyrogallol produce a dark red, the entire layer of ammonia quickly assuming the same color. With tannic acid the reaction is peculiar. The mixed test solutions assume an orange coloration and the ammonia becomes red, a green-colored line sharply making the srparation.

The author, in accord with others, questions the claims that have been put forth for the value of this test. While the absence of the reaction may indicate the absence of typhoid, the presence of the reaction does not warrant the diagnosis of typhoid unless sup. ported by other evidence, as many of the substances producing the reaction, notably phenol and peptone, may be present in the urine from other causes.

The Treatment of Chronic Valvular Disease of the Heart.-Dr. James Tyson (Amer. Jour. of the Med. Sciences) notes the relief obtained from the occasional use of purgatives-five to ten grains of blue mass, followed by a saline, or the continuous use of small doses-one-half to one grain thrice daily. In re gard to digitalis, the suggestion is made that the greater apparent effect of the infusion is due to its use in larger dose, although it is likely to be better borne by the stomach. Strophanthus, better borne by the stomach, has been used in doses of ten minims every two hours for forty-eight hours without interruption. Caffeine in three-grain doses every three hours, in mitral regurgi tation, is admirable, but is likely to produce insomnia. Sparteine in one quarter, increased to one half grain dose, three to five times daily, is valuable if a diuretic effect is desired. For irregularity of heart action and palpitation, which are more common in mitral disease, belladonna is a very useful remedy. A belladonna plaster placed over a palpitating heart is one of the most efficient agents in sub luing it; nitro glycerin, onehundredth of a grain, increased to double the quantity, three times daily, is often very useful to the same end.

dinary xanthomain adults, and diabetes mellitus bas 3. Jaundice is a very frequent accompaniment of or

never been recorded as occurring in association with it; corum, in which saccharine urine is a constant feature, the reverse is the case as regards xanthoma diabetiand jaundice is an unknown complication.

Ectopic Pregnancy.-Smith (New York Jour. Gyn. and Obst.) reports an interesting case of a II para (first child dead when born), to whom he was summoned on June 4, 1891. Patient had been seized with a terrible pain "weeding a flower-bed." She located this attack in the right iliac region. During the following weeks she had repeated attacks, until August 22, when she died. At the autopsy a mass the size of an orange was found in the right iliac region, involving the Fallopian tube and broad ligament. At one point of this mass the wall had become so attenuated that rupture had taken place into the peritoneal cavity. During the early history of the case some doubt had existed in the minds of the author and his consultants as to the character of the trouble, so that an operation was not considered justifiable.

Eclampsia and its Treatment.-Martin (Edinburgh Med. Jour.) reports a case of eclampsia occurring in a mill worker, twenty-one years of age. Family history good. Patient had complained of headache, especially in the morning. Labor was induced, and patient was delivered of a healthy child. The attacks occurred every twelve to sixteen minutes, and terminated fatally at the end of twenty-four hours. During the night preceding death the breathing was stertorous, and six hours before death Cheyne-Stokes respiration set in. No post-mortem could be obtained.

Porteous (Edinburgh Med. Jour.) advances the theory that there are five forms of eclampsia: (1) Hysteric, (2) epileptic, (3) uremic, (4) apoplectic, (5) microbic. In the microbic there are none of the signs or symptoms of ordinary eclampsia. The kidneys are not at fault; temperature varies little, and the pulse neither quickens Xanthoma Diabeticorum.-Mr. Malcolm Mor- nor becomes slower for any length of time.

MEDICAL SOCIETIES

14. Pathology of Pelvic Inflammatory Trouble, by Dr Joseph Price, Philadelphia.

Papers have been promised, without giving the subject, by Prof. Wm. H. Welch, of Baltimore; by Dr. W.

of Baltimore, and Drs. Wm. Hughes and W. J. Carter, of Philadelphia.

The Pan-American Medical Congress.-J. Councilman, of Boston; and by Dr. G. F. H. Nuttall, The program of the Section on Pathology is as follows: Special attention of the profession is called to the practical demonstrations in Pathology, Photo-Microscopy and Bacteriology.

One session devoted to a formal discussion on the subject of cancer to be opened by Dr. Wernicke of Buenos Ayres, and, as co-referee, Prof. Allen J. Smith, of Galveston. Papers on this subject have been promised by Dr. Joshua M. Van Cott, Honorary President of the Section, and Dr. Joseph McFarland of the Advisory Council.

Another session will be devoted to Yellow Fever, the discussion to be opened by Drs. Acosta and Grande, of Havana, Cuba, and as co-referee, Dr. A. J. Amades, of Puerto Rico, Honorary President.

John Guiteras, M.D., Executive President, Philadel phia, Pa.; David Inglis, M D, English Speaking Secre tary, Detroit, Mich; L. F. Criado, M.D., Spanish-Speaking Secretary, Brooklyn.

The Association of Military Surgeons of the National Guard of the United States.We are indebted to the Journal of the American Medical Association for the following abstract of the proceedings of the third annual meeting (first day-morn ing session) of this Association, held in Chicago, Ill., August 8, 9 and 10, 1893:

The Association met in the upper amphitheater of

One day, two sessions, will be devoted to Practical Rush Medical College, and was called to order by the Demonstrations, as follows:

Dr. James E. Reeves, of Chattanooga, of the Advis ory Council: Practical Demonstrations of the Methods in Pathological Histology.

Dr. Wm. M. Gray, of the Army Medical Museum: Practical Demonstration of the Methods in Photography applied to Pathology.

Dr. J. J. Kinyoun, Q. A. Surgeon U, S. Marine Hospital Service: Practical Demonstration of Methods in Bacteriology.

Papers have been promised as follows:

1. Notes on Three Years' Work in the Pathological Laboratory of the Charity Hospital of New Orleans, by Dr. Henry Dickson Bruns, of New Orleans.

President, Dr. Nicholas Senn, of Chicago, at 10 a. M.

In the absence of the Rev. H. W. Thomas, Chaplain of the Illinois National Guards, prayer was offered by Bishop Samuel Fallows, of Chicago.

President Senn then introduced the Hon. Carter H. Harrison, Mayor of the City of Chicago, who delivered one of his happy and characteristic addresses of welcome.

Dr. Truman W. Miller, of Chicago, addressed the members on behalf of the local medical professsion. He said, aside from presenting them with the active. scientific work in our institutions, we had to show them in our glorious White City, conceived by the wizard's brain and built by the touch of the magicians wand,

2. Medical Geography of Puerto Pico, by Dr. A. J. exhibits from all nations of the latest appliances, methAmades of Puerto Rico.

ods and preparations known or used for the advance

3. Theories of Inflammation, by Dr. Sose Torres ment of medical and surgical science, and it was with Matos, of Havana.

great professional pride that he invited their attention 4. On Inflammation, by Dr. E. O. Shakespeare, of to the exhibits made by the government through the Philadelphia.

officers of the Army, Navy, and Marine Hospital Ser

5. On Cholera, by Dr. Herman M. Briggs, of New vice, together with those of our universities, feeling that York.

6. L'etat de Hyperexcitabilite du Nerf Phrenique, dans le Beribiri, by Dr. J. B. de Lacerda, of Rio de Janeiro.

7. Paludismo, by Dr. A. J. Amades, of Puerto Rico. 8. Bacteriological Observations on the Waters of the Harbor of Havana, by Drs. Acosta and Grande.

they would be convinced that we were rapidly progress. ing in, scientific investigations. Medical men had always been expected to give a large part of their services for the relief of the human race without a full recognition of their value, but he believed that a well established association of military surgeons would command the respect and a position in military organizations In every State an effort should be made to advance the standard

9. Observations on Malaria, by Drs. Coronado and which could be attained by no other means. Madua.

10. Operations of the Anti-Rabic Laboratory in of its medical staff. Havana, by Dr. Acosta.

Dr. Albert H. Briggs, of Buffalo, in the absence of 11. Abscess of the Liver, by Dr. James E. Reeves, Dr. Lewis W. Read, of Norristown, Pa., responded for of Chattanooga. the Association and thanked the local committee for

12. On Influenza, by Dr. Ramon Guiteras, of New their warm greeting. York.

The report of the Committee of Arrangements was 13. Observations on the Brains of Feeble Minded then made by the Chairman, Dr. Charles Adams, of Children, by Dr. Henry W. Cattell. Chicago. He announced a reception to be given by

President Senn in the evening, and a theater party on
Wednesday evening.

Maj. Nelson H. Henry, of New York, First VicePresident, then took the chair and President Senn delivered his address. He selected for his subject, "En terorrhaphy; its History, Technique, and Present Status."

The address was listened to with marked attention, and at its close a vote of thanks was extended to President Senn for his exhaustive and highly interesting resume of the subject of the intestinal nature.

An executive meeting was announced for the morning of the second day at the United States Army Hospital at the World's Fair grounds. The Association will then discuss the practicability of changing its name to "The Association of Military Surgeons of the United States," and its scope wi be enlarged to include the medical staff of the Army, Navy and Marine Hospital Corps.

Arrangements will be made for an international congress to be held in this country in 1894. Steps will also be taken to memorialize Congress concerning the estab lishment by the government of a military medical school,

Two Cases of Tuberculosis Verrucosa Cutis of the Hand.-Dr. Bulkley presented before the New York Dermatological Society:

1. Chas. B., a laborer, native of United States, 23 years old.

The lesions on the dorsum of the left hand have been present about seven years.

Patient's mother had died of phthisis at the age of 60 years. Patient nursed by her during her illness.

The disease began as a "lump" upon the web between the second and third fingers. From this situation the trouble spread steadily to the back of the hand. When the patient came under observation, last May, there was a patch of disease four square inches in extent upon the dorsum of the hand. The diseased area was characterized by general infiltration, tubercles and nodules, all of soft consistency and marked here and there by pustules and small ulcers. There was no cicatricial tissue.

Now there is present an infiltrated area over the first right knuckle, of red color, not sharply defined, shading gradually into healthy skin; the lesion is not painful; slightly raised with slight solution of continuity in severol places of the surface.

Dr. Fow said in regard to the treatment of such cases that Unna's ointment of 20 per cent. solicylic acid and creasote acted admirably after a brief treatment with the curette.

Dr. Klotz said that he doubted the tuberculous nature of many such cases, they more resembled lupus erythematosus or belonged to a class recognized by Leloir, which presented some features of lupus and some of lupus erythematosus. He had at present under observation a boy with a similar eruption of the hand, which some time ago had been presented before another Society as tuberculosis verrucosa cutis. He hoped to bring the case before the Society at a future meeting. The lesions healed under the permanent application of a 10 per cent. salicylic acid plaster without leaving the slightest scar. This he would not consider possible in a case of tuberculosis. He thought that the scars in such cases were entirely the result of the treatment.

Dr. Bulkley stated that he insisted only on the clinical resemblance of these cases to tuberculosis verrucosa; he believed that they could be cured without any deeper destruction of tissue.

Investigation on the Anatomy of the Cervix.-Knupffer (St. Petersburg. medicin. Wochenschrift), after a number of experiments on bats, has de

monstrated that birth must ensue when the cervix has widened sufficiently for the descending part to make pressure on the nerve ganglia found at the point of the vaginal insertion; pressure on these ganglia producing contraction of the uterus. After a portion of the pregnancy has passed, the uterus rising beyond the upper border of the lateral ligaments, the enlargement of the cervical canal allows the ganglia to be forced nearer and nearer to the wall of the canal. As gestation advances, the lower uterine segment is formed. The mesometric ganglia become more and more conspicuous, and the cervix not only expands upward but presses toward the The treatment has been the repeated use of the cu mesometrium The fundus continuing to rise, a merette under cocaine and the occasional application of chanical stimulation of the upper ganglia takes place, the Paquelin cautery. The wound was invariably dressed with dermatol. The last curetting was done about the middle of January, 1893.

causing the first light contractions. With the deeper descent of the fetus, the cervix is stretched and the presenting part approaches the great ganglia, which are prevented by the mesometrium from withdrawing, and the presenting part is allowed to press on the deep ganglia, which are more numerous and larger, and thus strong uterine contractions are set up.

2. B. M., 11 years of age. Eruption appeared be tween four and five years ago, in shape of small red spot on first knuckle of right hand; was not raised nor painful, nor caused any other subjective symptoms. It disappeared again, but grew slowly larger, and at times became covered with thin red scales; it was never Orificial Surgery.-The next annual class for picked nor injured otherwise. The patient did not pre-instruction in orificial surgery will assemble in Chicago sent any other eruption elsewhere. Father died of ty- on the morning of September 4. It will have a four phoid. From five children, the oldest died at 3; would hours' daily session during the week. For particulars be 17 years old now. The four remaining children are address, Dr. E. H. Pratt, R. 56, Central Music Hall, perfectly well; mother living and healthy. Chicago.

and finally apply chloroform-or ether will do as well if chloroform is not at hand. Any seams coming with in the space to be cleaned will require careful attention just as the nails will if the hands are to be deodorized.

Impending Resignation of Professor He- The proper way for the nails is to dip a bit of soft noch.-Professor Henoch, Director of the Clinic of wood (a match whittled flat is handy and efficient) in Children's Diseases in the Charite Hospital, Berlin, has chloroform and with this clean under the nails. I have intimated his intention of resigning his chair at the derived great comfort from applying this method in Professor Henoch, whose daily practice."

end of the current semester.

name is known throughout the medical world as the author of a standard treatise on the diseases of children, The Medical Corps of the United States is seventy-three years of age, and has held his present Army.-In the overcrowded condition of the proappointment for forty three years. The names of Profession, together with the resultant limitation of opporfessor Kohts, of Strassburg; Soltman, of Breslau; and tunity in private practice, the recent graduate in mediHuebner, of Leipzig, are mentioned in connection with cine will find much to attract him to the Medical Corps the chair which will be left vacant by Professor He- of the United States Army (Med. News). The standard of requirements is of course elevated, and the appointment is, therefore, the more highly to be prized. Recent innovations, to which allusion has already been made, have, besides, greatly elevated the desirability of the positions in the Corps.

noch's retirement.

The Value of the Hands and of the Fingers. Surgeons have often to estimate the chances of saving injured hands, and the comparative values of hands and fingers. According to a scale of value furnished by the Miners' Unions and Miners' Accident Insurance Companies of Germany, the loss of both hands is valued at 100 per cent, or the whole ability to earn a living. Losing the right hand depreciates the value of the individual as a worker 70 to 80 per cent, while the loss of the left hand represents from 60 to 70 per cent of the earnings of both hands. The thumb is reckoned to be worth from 20 to 30 per cent of the earnings. The first finger of the right hand is valued. at from 14 to 18 per cent, that of the left hand at from 8 to 13.5 per cent. The middle finger is worth from 10 to 16 per cent. The third finger stands least of all in value; although, like other useless members of the community, it is surrounded by riches, its value is only from 7 to 9 per cent. The little finger is worth from 9 to 12 per cent. The difference in the percentages is occasioned by the difference in the trade, the first finger being, for instance, more valuable to a writer than to a digger.

To Get Rid of the Odor of Iodoform.-Dr. W. Washburn, of New York, (Med. Rec.) writes a propos of a recent item on the deodorizing of iodoform: In the Medical Summary for June, 1893, an article by myself gives an easier and more convenient method. It is there stated that both ether and chloroform are solvents of iodoform, and will remove every trace of it and its odor if the hands are washed with them a trifle afterwashing with soap and water, The hands have a pecu liarly clean feeling after using chloroform, dry instant ly, and require no further washing. As nearly every physician carries ether or chloroform in his satchel, and as turpentine would be an additional burden, there is this also in favor of these drugs, they are always at hand. When clothing has been saturated with iodoform the proper thing is to first apply chleroform to the spot and rub it in, then wash with castile soap and water,

In the organization of the Army Medical School four professors will be selected from among the senior medical officers of the army stationed in or near the city of Washington, and as many associate professors as may be required to give practical laboratory instruction in the methods of sanitary analyses, microscopic technic, clinical microscopy, bacteriology, urine analysis, etc. The faculty of the Army Medical School will consist of:

1, A President of the Faculty, who shall be responsi ble for the discipline of the school, and who will deliver a course of lectures upon the duties of medical officers in war and peace (including property responsibility, examination of recruits, certificates of disability, reports, rights, and privileges, customs of service, etc.).

2. A Professor of Military Surgery (including the care and transportation of wounded).

3. A Professor of Military Hygiene (including prac tical instruction in the examination of air, water, food, and clothing from a sanitary point of view).

4. A Professor of Clinical and Sanitary Microscopy (including bacteriology and urinology).

The position in the Medical Corps is a most honorable one. The pay and emoluments are quite reasonable, while original investigation and study relating to scientific medicine or hygiene will receive due encouragement.

There are at present five vacancies in the Corps, and five more will occur within a year. To save unnecessary expense to candidates, those who desire it may have a preliminary physical examination and a mental examination in the "elementary branches of a common school education" by a medical officer of the army stationed most conveniently for this purpose. will enable those who would be rejected on account of physical defects, or whose preliminary education is unsatisfactory, to ascertain the fact without going to the expense of visiting a distant city for the examination,

This