aborts felons, and is much better than the soap and sugar and other compounds of household practice. The ingrown nail can be treated by scraping a notch and clip to keep the flesh away from the nail. In severe cases it may require the removal of a portion of the nail and redundant skin. Warts will almost always disappear under daily painting with salicylic acid in collodion (5 per cent) solution, excepting in the acuminate type. Other remedies which he uses are formalin solution, corrosive sublimate, and sulphur. Corns and bunions are sacrifices to civilization, and the original conditions are relieved by the wearing of properly adjusted shoes and protecting the part with a simple cotton and collodion dressing. A useful and convenient remedy is tincture of iodin. Bathing in starch water is also advisable, and should be practiced twice a day. He speaks in condemnation of the commoner practice of letting chirpodists work on the feet with a knife that is always unclean, helping only to promote disease and the practice of the operator. For the soft corn between the toes, ordinary greasing and putting a film of cotton over it usually will suffice. Salicylic acid plaster, 10 per cent, is useful for flat corns not especially painful. Most of the local applications are suitable, but the above seem to be the ones here especially recommended.-Journal American Medical Association.

more.

Special Notices.

OWING to the great increase in the substitution of inferior and harmful remedies for those of well-known and proven value, we advise purchasers, for their protection, to insist on having Celerina, and not to accept any thing that is offered as "just as good." or cheaper, which unscrupulous druggists continue to offer in order to make a few cents You know what you want, insist on having it; if he has not got it, go somewhere else, or get him to order it for you. We think this will explain to you the necessity of getting the genuine article, in order to produce satisfactory results, for in some cases of failure it has been owing to the substitution of an inferior article, thus not only doing you no good, but even imperiling your life. But as this hydra-headed monster, like Banquo's ghost, "will not down" as long as dishonest men exist, the best way to check it is to purchase in original packages, and be sure that you get in that form.

TO REMOVE FROM THE HANDS THE ODOR ACQUIRED IN MAKING A POST-MORTEM. Every physician who has had occasion to make a post-mortem examination is familiar with the peculiar cadaveric odor which clings so tenaciously to the hands. Those also who have treated uterine cancer know the sickening odor of the vaginal discharges, and how impossible it is to wash it from the hands. In such cases the hands should be washed thoroughly with warm water and soap, and then listerine applied full strength. If listerine had no other use than this it would be of great value, but beside this, it is of inestimable value as an antiseptic, either internally or externally.-Massachusetts Medical Journal.

SANMETTO IN UTERINE CONGESTION.-Dr. M. J. Halsey, of Fowler, Ind., writing, says: “I have found Sanmetto perfectly satisfactory, and I take pleasure in recommending it in cases of uterine congestion, having tried it and proved its efficacy in such a case. I have placed it in the foremost of my list of favorite remedies for congestion of any mucous membrane in the body."

Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than any thing else.-RUSKIN.

Original Articles.

PREPUTIAL DIVULSION VERSUS CIRCUMCISION IN THE YOUNG.

BY JOHN B. ENRIGHT, A. M., M. D.

Professor of Anatomy and Instructor in the Laboratory of Anatomy in the Kentucky School

of Medicine.

And at the present The boy, no matter

It has not been many years since the removal of ovaries was such a custom that any woman who ventured to get on an operating-table usually left it minus her primal generative organs. day almost the same can be said of the prepuce. how perfectly formed, is only too frequently the victim of semicastration, or, in other words, robbed of the hood that protects his balanitic extremity. A reckless and seemingly unwarrantable sacrifice of the prepuce is made on the altar by old as well as young and enthusiastic surgeons. Let us examine this question to see what are some of the benefits to be derived, as well as any harmful results that may ensue, and at the same time consider if or not divulsion is not the better as well as the more physiological desideratum. Dismissing circumcision as a religious rite, let us inquire into the feasibility of its performance both from a hygienic and physiological standpoint.

When there is great redundancy there is no question but what the operation is called for. But, on the other hand, when the glans penis is only scantily covered while in a flaccid state, the operation is just as strongly uncalled for, and many good reasons can be advanced to show that the procedure is not only unwarranted, but is, in many

cases, absolutely contra-indicated. Many boys are born with a partial phimosis, no redundancy; but, on the contrary, a seeming paucity of foreskin. These are the favorite subjects of the surgeons who have a mania for practicing circumcision, and they are forever afterward ball-headed possible votaries that may remotely worship at Sodomy's bestial shrines. However, if not circumcised, why not? and what have you to offer in lieu that is better.

In the writer's opinion divulsion is par excellence the better thing to do. By circumcision we rob the glans penis of its normal protection and forever expose it to the rubbing and friction of the wearing apparel, which is not always of the softest consistency, but is often composed of the coarsest kind of fabric. This exposure results in the glans penis becoming callous and bereft of that tenderness and perfect development of the end "bulbs of Krouse" which are requisite for the acme of gratification to be experienced during the copulative acts in after years. Not only is this true, but experience and observation warrant the statement that even in the marital state, on account of this benumbed condition and failing to get this natural passion gratified, and unless strongly fortified by a superb moral equilibrium, a circumcised victim will only too frequently wander away from home to bestial haunts, where he seeks in vain satiety by having this callous head warmed and drawn by the lowest of unnatural methods. These are some of the things circumcision often leads up to. On the other hand, by the careful introduction of a pair of blunt-pointed forceps (closed) into the preputial orifice and gently breaking up any adhesions that may exist between the inner layer of the prepuce and the limiting membrane of the glans penis, the operator is usually able to get the extremity of his forceps back to the cervix, and then gently opening the handles of the forceps, the blades will likewise separate and stretch the prepuce.

By the use of some antiseptic lubricant the foreskin can be made to glide backward and forward over the glans penis. It is seldom that more than a few drops of blood are lost as a result of the tissues being stretched. Usually when the prepuce is retracted for the first time a more or less quantity of heretofore confined smegma will be found in masses adjacent to the cervix. These vary in size from a millet seed to that of the half of a good-sized bean. When these masses are removed they are usually hard, and a constant source of irritation has been eliminated. The enureses of baby boys, the kicking off

of bed-clothes at nights or other times, the tardiness in learning to talk, even stuttering and stammering, and many other nervous phenomena are frequently due to irritation of the glans penis and to the prepuce being too tight. Divulsion of the prepuce removes the cause of the disturbance and usually results in all these various perverted nervous manifestations disappearing. In neglected cases it may be necessary to dissect off the prepuce from the glans penis on account of the organization that has taken place between the two. This is somewhat tedious, but a little patience and perseverance will reward the operator with finding the cervix.

Not long since a young man, nineteen years old, consulted me, and I found his prepuce firmly adherent as far forward as the meatus urinarius externa. I cocainized the parts and proceeded to dissect. When I was about half way back, the sensibility having partly returned, the young man suggested that we wait until the following night to complete the operation. The next evening I finished it, and found two very large, half-bean-shaped pieces of smegma that had undoubtedly been there for years. When a penis is otherwise perfectly formed save a more or less narrowed condition of the prepuce and not an excessive redundancy, divulsion is certainly the proper operation. A tight prepuce is a cause of masturbation, the irritation there causing a fondling that soon leads to the habit. Divulse thoroughly, so that the penis can be kept clean, and the habit is not likely to be formed.

Conclusion. When a prepuce is narrow, divulse it, and especially in children, where the absence of diseased conditions is the rule. Never circumcise a non-diseased child unless there is great redundancy, and even then leave an abundance of foreskin, and by all means leave the frenum intact; for at best the glans penis will become callous, and reason tells you that as the boy reaches maturity he can not experience that acme of gratification which he would otherwise enjoy were his organ in its pristine condition.

LOUISVILLE.

THE MANAGEMENT AND TREATMENT OF TYPHOID FEVER.*

BY G. L. BARR, M. D.

Member of the Kentucky State Medical Society, Daveiss County Medical Society, etc.

You will pardon me if I ask your indulgence in a paper on a subject that has been worn threadbare. Though discussed by all, we have only approached the land, anchored in a small inlet, and picked up a few pebbles along the beach of this great ocean of typhoid fever.

This a disease that claims its victims of all ages, from the cradle to old age; so I shall not invite your attention to any thing novel in the management or treatment of typhoid fever, but simply give the result of my personal observations, and endeavor to deduce from this and the current literature on the subject what I conceive to be the most rational and practical management and treatment of this disease.

I do not accept any specific treatment of typhoid fever, hence no hard or fast lines in the management or treatment can be drawn. The disease is of a complex nature, presenting several types, many aspects, and numerous complications, consequently all cases can not be managed or treated alike; hence in a paper of this scope only a general management and treatment can be suggested.

The management of typhoid fever which meets with my approval is characterized not so much by brilliant therapy as by common sense and the application of simple, well-tried agents. If our patient is hot, we give him cool drinks; if he is wasting, we give him nutritious, easily-digested food; if the heart is weak, give tonics and stimulants. Place the patient in the most comfortable and pleasant room in the house-a room that is well ventilated, plenty of light, and as free from noise as possible.

The doctors that have to treat this disease in the country have many cases in the cabins without shade, cool water, or a good, intelligent nurse, hence we are taxed to determine what is the best we can do. After having our patient as comfortable as possible, a good nurse comes next. A competent trained nurse is best. Having done this, we may summarize the principles of management under the following heads: I. Control the fever within reasonable bounds.

2. Maintain the strength by judicious feeding.

3. Meet special symptoms and complications by suitable remedies. 4. Care and scientific nursing prolonged through convalescence.

* Read before the Daveiss County Medical Society, at Owensboro, Ky., September 11, 1901.