by a close observation of a large number of cases. That it does produce sterility, in the great majority of cases, is well known. It is also reasonable to suppose that one mode of operating is more likely one ounce of the salt in a quart of water. To preserve beer, wine, etc.; it is sufficient to rinse the bottles, previous to filling them, with a solution of the salt in the proportion of one to ten, and adding to the beverage itself eight grains per quart. For to produce it than another. Yet surgeons are not fish, lobsters, oysters, fruit and vegetables the preparation has also been used with the best success. TREATMENT OF EPITHELIOMA OF THE CERVIX UTERI. Dr. J. Marion Sims (American Fournal of Obstetrics, July, 1879) describes his operation for this affection, illustrating the subject with carefully designed engravings. We give the conclusions of this valuable paper, referring the reader to the above named journal for the article in full : "1. Do not amputate or slice off an epithelioma of the cervix uteri on a level with the vagina, whether by the écraseur or by the electro-cautery. 2. Exsect the whole of the diseased tissue, even up to the os internum, if necessary. agreed upon this point. It would be a great triumph in surgery to determine the exact cause of sterility, and to devise some plan which, while avoiding such an unfortunate and unhappy result, would not lessen the chances of recovery and relief from so painful and distressing an affection. Unfortunately the information afforded in the history of these cases will not assist us much in arriving at any conclusions on this point. The result of the operations bearing on sterility or non-sterility have only been mentioned in a few cases. I allude to this point more particularly, because Dr. T. T. Robertson, of Winnsboro, calls attention to two cases of sterility, one in his own practice, the other in one of Prof. E. Gedding's patients; and Dr. 3. Arrest the bleeding, when necessary, with a Ogier mentioned to me that the same had occurred tampon of styptic iron or alum in cotton-wool. 4. Be careful not to apply the tampon with such force as to lacerate the excavated cervix uteri. 5. When the styptic tampon is removed, cauter ize the granulating cavity from which the disease was exsected with chloride of zinc, bromine, sulphate of zinc, or some other manageable caustic capable of producing a slough. 6. After the removal of the caustic and the slough it produces, use carbolized warm water vaginal douches daily till cicatrization is complete. 7. After the cure, put the patient on the use of arsenic as a protection against the cancerous diathesis, and urge the importance of examination! every two or three months for the purpose of detecting the recurrence of disease. 8. Then if fungous granulations or knobby protuberances not larger than a pea are found, lose no time in removing them; and treat the case afterward with caustic just as in the first instance. 9. Almost every case may be benefited by operation, even when there is no hope of giving entire relief." Dr. Sims gives Dr. Reamy, of Cincinnati, credit for working out this method of operating independently, and publishing it about the same time. Dr. Reamy uses scissors, and endeavors to remove the entire growth in one piece; Dr. Sims exsects the cervix piecemeal. to one of those he had operated on, and he believed that it was nearly always attended by this effect. One of Dr. Crook's and two of Dr. Bartlett Jones' were also sterile. Professor F. M. Robertson's patient has several children; so have the patients of Drs. Miles and Daring and one of Dr. Campbell's. These cases were all bilateral or lateral operations, and three of them with the same instrument, yet the result was very different. How are we to explain these different effects of the same operation with the same instrument upon separate persons? ORIGIN OF THE STETHOSCOPE.-One day as he (Laennec) was crossing the court of the Louvre, he observed some children who, with ears applied to the two-extremities of a long beam, were transmitting reciprocally the light sound provoked by the stroke of the finger against the opposite end. In the intermediate space no sound was perceptible. The careful observer reflected, and soon, like Archimedes, he was able to exclaim, “I have found it." Some time afterward, in fact it was in 1816, being consulted for a young woman who presented general symptoms of heart disease, in which percussion gave small results on account of the stoutness of the subject, the age and sex of the patient forbidding his listening directly with the ear, he remembered the children of the court of the Louvre. Immediately he took a paper copy-book, of which he made a roll closely pressed together, placed one end of it upon the chest of the young woman, applied the other to his ear, and found with pleasure that in that manner he could perceive much more The relation which this operation bears to sub-clearly the beats of the heart. So a play of childsequent sterility is of great interest, for several reasons which readily suggest themselves, and it is a question by no means settled. It can only be done STERILITY AS The Result of LITHOTOMY.--In Dr. Parker's study of 131 cases of lithotomy in the Transactions of the South Carolina Medical Association (Cin. Lancet and Clinic), he says, on the above point ren and regard for modesty, were two facts which led to the discovery of medical auscultation. Laennec then modified this roll of paper, giving it more firmness, limiting its length to a foot, its diameter to sixteen lines-smoothing the two extremities with a file. Then he made other experiments: He constructed a tubular cylinder of goldbeater's skin, which he filled with air by means of a spout, and of which the central opening was maintained by means of a support of pasteboard; he made an experiment with glass and metals; finally he stopped with a cylinder of light wood, pierced in its centre with a tube, expanded at the extremity in the form of a funnel. We have seen in our youth the original stethoscope of Laennec. In truth, it had a size altogether useless and well adapted to terrify patients.-A. Chereau, in Arch. Gen. de Med., July, 1879.-St. Louis Courier of Medicine. EXTRACTION OF BILIARY CALCULI.-A remarkable case has been recorded by Dr. Anger, of Menilmontant, in which a hundred biliary calculi were extracted through the abdominal wall. The patient was a woman, sixty-three years of age. When first seen the abdominal wall was perforated by many fistulous openings in hard red indurated tissue, situated above and below the umbilicus. For thirty years she had suffered frequent attacks of hepatic colic, and in 1874 had an attack of jaundice. In April, 1876, a red painful prominence appeared just above and to the right of the umbilicus, and the swelling spread rapidly over the abdomen and to the right leg. The prominence ultimately burst with a sound like the opening of a champagne bottle, and watery matter, of fæcal odour, escaped. Soon afterwards small sloughs appeared on the lower part of the abdomen, leaving orifices through which many small biliary calculi passed. With a probe passed in through the highest opening many biliary calculi could be felt about five centimetres from the surface. This orifice was dilated by tents of laminaria, and through it more than a hundred calculi were extracted with dressing forceps. The other fistulous openings were enlarged, alcohol dressings applied, and all slowly healed. The patient's recovery was complete.-Lancet. OPIUM INEBRIETY-ITS TTEATMENT AT FooCHOW, CAINA. Dr. Osgood (Quart. Four. In. ebriety, June, 1879), has in a hospital during the past two years treated 800 cases of opium inebriety. His plan in general is: (1) The absolute and total discontinuance of the use of opium from the beginning of treatment. (2) A trusty attendant to be with the patient day and night for the first three days. (3) Chloral hydrate for the first three nights if required. (4 Good food, milk, raw eggs, brandy (in some cases), chicken broth. (The above to be taken in small quantities). (5) In diarrhoea, give two-drachm doses of a mixture of equal parts of tincture catechu and tincture of gin ger. (6) Vomiting will frequently yield to bismuth in fifteen-grain doses; and in some cases a single dose of calomel has acted like a charm. Ice is of advantage in some cases. (7) Throughout the entire treatment it should be remembered that the patient is below par, and requires tonics. Quinine and tincture of iron have a prominent place in our list. (8) The patient should expect to suffer more or less for the first three days, and should make himself a prisoner for that time. By the fourth day there is usually marked improvement. (9) Usually by the sixth day all desire for opium is gone. The patient then requires a change of air and surroundings, and tonics for a few weeks. Out of one hundred cases thus treated there was but one death, and that from apoplexy.-Detroit Lancet. A SIMPLE FORM OF BUTTON-SUTURE.-In the January number of the Glasgow Med. Journal, page 59, for this year, we noted incidentally the employment of this form of suture by Dr. MacEwen, in a case of amputation of the leg, and we are led to refer to it again, as it does not appear to be so generally known as, from its efficiency and simplicity, it deserves to be. It consists simply of a disc, preferably of zinc, of about 3/4 inch diameter, and perforated by two holes, instead of one, as in in the common form. Two wires are used for each stitch, one for each hole in the button, and these, when passed through, are twisted on each other. The suture is, of course, fixed at the other end in a similar way. If it be thought advisable to tighten or relax the stitch, the wires can easily be untwisted and fixed again. Zinc is a convenient material to employ. It corrodes less, and is less irritating than tin. The edge can be turned up should it press unduly on the tissues, or a half turn of the button occasionally may be sufficient. Ogilvie Will has brought before the notice of the profession, in the British Medical Journal, 21st June, 1879, a more complicated form of disc, the cost of which must be a great objection to its general employment. In his paper, and also in one of Mr. Lister's, "On Recent Improvements in the Details of Antiseptic Surgery" (1875), an account of the use of this kind of suture in surgery will be found, to which we refer for fuller details. Dr. Dr. T. Grainger Stewart has discovered that when, during the administration of the tincture of the chloride of iron, functional derangements of of the stomach and liver arise, with furred tongue, impaired appetite, headache, etc., these symptoms rapidly disappear upon adding one half grain of of the chloride of ammonium to each minim of the tincture. He finds this combination notably useful in cases of heart disease accompanied by anæmia and debility.—Boston Med. Fournal. CODEIA AS A SEDATIVE.-No symptom is more distressing to a patient than frequent coughing, and none demands more judicious treatment on the part of a practitioner, if he would avoid undoing with his cough mixtures all the good he is attempting by his more general therapeutic measures. In phthisis the presence of anorexia makes us unwilling to give opium or morphia, and frequently when we do so we have reason to regret it. Many patients, especially gouty subjects and those who suffer much from derangement of the liver, are intolerant of opium and morphia. On account of these difficulties I have been led to employ codeia in such cases, in the hope that it might be of service, and it has succeeded beyond my anticipations. In phthisis it allays cough without disturbing the digestive system; and in the other class of cases I have found it tolerated when opium and morphia were not. I prescribe the drug in doses of a grain dissolved in syrup of tolu.-British Medical Fournal. TREATMENT OF ULCERS.-The method found most serviceable in the New York Hospital (N. Y. Med. Journal) has been a combination of that used by Lister with the india-rubber bandage of Martin. The ulcer is first washed with a 1-20 solution of carbolic acid, then covered with a piece of the "protective" oiled silk, over which is placed one or two larger layers of lint or felted paper, which has been previously dipped in a saturated solution of boracic acid. The whole is then covered with an elastic bandage, which is only changed when it becomes soiled by the discharge. Occasionally it is found better to take off the elastic bandage at night, but not the other dressing, which is then covered by a piece of impermeable tissue, such as thin gutta percha or waxed paper secured in situ by an ordinary bandage. In sloughy ulcers a layer of iodoform is put over the surface before applying the "protective." The rapidity of cure by the combination treatment has been found to be much greater than when either the Lister dressing or the rubber bandage is used alone. ROYAL COLLEGE of Surgeons of ENGLAND. At a meeting of the Council on the 10th instant, Mr. Luther Holden of Gower Street, Bedford Square, Senior Surgeon to St. Bartholomew's Hospital, was elected President of the College, in the vacancy occasioned by the retirement of Mr. John Simon, C.B., F.R.S.; and Mr. J. E. Erichsen, F.R.S., of Cavendish Place, Surgeon to University College Hospital, and Mr. Erasmus Wilson, F.R.S., of Henrietta Street, Cavendish Square, were elected Vice-Presidents for the collegiate year. At this meeting of the Council, the recently elected members of it-Messrs. John Wood, F.R.S., Henry Powe and Jonathan Hutchinson made the necess ary declarations, and took their seats. The several professors and lecturers were re-elected. OBSTETRIC PRACTICE IN SIAM.-Medicine, and particularly obstetrics, seems to be in the most primitive condition in this country. Labor cases are generally attended only by ignorant women. If there is an emergency, male physicians are called in, but these are quite as bad as the midwives, and rely chiefly on incantations and absurd compounds for producing relief. To hasten on the uterine contractions the abdomen is pounded and kneaded, or even jumped upon. After delivery a most painful ordeal has to be gone through with. The woman is placed as close as possible to a hot fire, and she is obliged to continue beside it for thirty days, suffering the agonies of a scorching heat and being only allowed hot water to drink. The custom is very firmly rooted, and no amount of persuasion will make the women do away with it. It has a certain scientific basis, from the Siamese standpoint, for it is believed that after parturition there is a diminution of the fire element in the system which causes the evolution of all sorts of bad humors.-Archives of Med. WHEN ARE INVOLUNTARY SEMINAL EMISSIONS PATHOLOGICAL ?-Dr. George M. Beard (Med. Record, June 14th, '79), says: (1) When they are followed by headache, languor, depression, nervousness and pain, local or general. (2) When, after long intervals, they occur several times a night, or a number of nights, in succession. (3) When the emissions are induced by slight reflex irritation or subjectively by mind acting on body. (4) When they accompany or follow acute or chronic disease and disappear with the disease. (5) When they take place in connection with any of the stages of impotence, and even when there is opportunity for perfect intercourse. (6) When the emissions occur at stool, or flow out with urine. Opening of DEEP ABSCESSES.-John Ashurst, Jr., M. D. (Med. News and Library, April, 1879), advocates the method of opening deep abscesses among the muscles as practiced by the late Mr. Hilton. This plan consists in making a small incision through the skin and superficial fascia, and then thrusting a blunt groved director through the intervening tissue until the abscess cavity is reached. Then dressing forceps are introduced closed along the director and opened and then withdrawn, with a twisting motion, thus dilating and lacerating the parts so as to prevent closure before the abscess is healed. TREATMENT OF ASTHMA.-Dr. S. G. Armor says: In the treatment of asthma, the iodide of potassium is the remedy. But there is a class, in which there is an inflammatory element, that not unfrequently resists that treatment. For these he A Case of Double Uterus & SUPERFETATION. is in the habit of prescribing a preliminary treat- Dr. Sotschawar, of Moscow, reports the case of a ment of divided doses of the bi-chloride of mer-woman, aged twenty-six, to whom he was called on cury, one-sixteenth to one-twentieth of a grain, for account of hemorrhage. Upon examination he two or three weeks. found two vaginæ, each leading to a distinct uterus. The hemorrhage proceeded from both uteri, and was very considerable. After some manipulation an embryo of about one month was abstracted from the left uterus, and three days later a fetus of three months from the right uterus. The observer asserts that this is the third case of the kind known to science. It may be remembered that Dr. Fordyce Barker, of New York, has had one such case in his experience.-Medical Record. Under this drug the exudation becomes less viscid and tenacious, and the subsequent exhibition of the iodide of potassium becomes more efficient. Dr. Armor gave an account of two very stubborn cases, the cure of which was brought about under this plan. Med. News. 1. Do CHRONIC BRIGht's Disease.-D. N. Guice, in a communication to the American Bi-weekly, gives the history of a case of chronic Bright's disease apparently cured by the use of iodide of potassium. IS PHTHISIS CONTAGIOUS ?-Dr. Wm. Porter of The patient, aged 50, had suffered from malaria, St. Louis, propounds the following questions, to but no history of syphilis was given. He became which he invites answers from all sources: affected with Bright's disease, with all the charac- you believe that phthisis is in any sense or degree teristic bad symptoms. His urine contained a contagious? Upon what practical evidence do you large amount of albumen, together with granular found your belief? 3. Please state the principal and hyaline casts. Iodide of potassium was ordered features of the case you have observed which have in doses of grs. v. three times a day, and this was direct bearing upon the theory. gradually increased to grs. xij. during the course of treatment. The symptoms slowly improved, and by the end of six months the patient appeared in every respect well. Iron and bitter tonics supplemented the potash. Five other cases of the successful use of the iodide in this disease have been reported.-N. Y. Med. Record. LARGE DOSES OF IRON IN HEART DISEASE In the Practitioner, Dr. T. Grainger Stewart finds improvement follow the use of cardiac tonics, particularly iron, in disease of the heart characterized by pallor, restlessness, headache, slight dropsy and breathlessness. Dilatation and partial failure of the heart's action are usually found with these symptoms. He gives the tincture of perchloride sometimes to the amount of twenty minims every two hours, more frequently every four hours, continuing its use for days together. In many cases improvement follows very speedily. To obviate the gastric derangement so often following upon the use of iron, he combines the chloride of ammonium with it, half a grain to each minim of the tincture. The combination renders the administration of iron possible in patients who otherwise can scarcely use it; indeed, in no other way can iron be administered in suffieient quantities to afford relief, and in many instances to save life. Western Lancet. A DARING OPERATION.-An operation was recently performed by Péan, of Paris, which for boldness is perhaps unique. The patient was suffering from cancer of the pyloric extremity of the stomach, completely blocking up the passage. He removed the pylorus and stitched the severed end of the stomach to the duodenum. The patient died on the fifth day. In consequence of the illness of Prof. von Ziemssen, who has undertaken personally to write the volume on "Diseases of the Skin," vol. 9, of "Ziemssen's Cyclopædia," Messrs. Wood and Co., the publishers, have issued a notice to subscribers that it is probable that this volume will be delayed for some time to come. HYDROBROMIC ACID IN STOMACH DISEASES :—Hydrobromic acid in the proportion of half a drachm to an ounce of water, four times a day, is said to arrest the vomiting attendant on ulcer of the stomach, and to enable the retention of solid food. This remedy may also prove of value in controlling nausea from other causes. A CONGRESS of Italian physicians which met at Pisa some time ago came to a very probable conclusion that suicide was much promoted by the reports of cases which appear in the public news DR. RICHARDSON'S STYPTIC COLLOID (Hospital papers. Gazette). R Acidi tannici, zii; Alcoholis absoluti, f3ss; Collodion, q. s. ad fzxij.-M. A FINE and life-like portrait of the late Mr. John Hilton has just been presented by his widow to the Council of the Royal College of Surgeons. It is by Mr. Herberi Barraud, and is a great suc cess. THE CANADA LANCET. A Monthly Journal of Medical and Surgical Science Issued Promptly on the First of each Month. Beurman has published an interesting work, in which the causes of mortality in parturients are studied. The author commences with a description of the arrangements of the Lariboisiere hospital, and the system of ventilation employed in it. He has ascertained the number of labours which occurred from 1854 in the ward of Sainte Anne, in this hospital, as well as the number of deaths reAGENTS.-DAWSON BROS., Montreal; J. & A. MCMILLAN, St. John, sulting. He divides these deaths into three classes: Communications solicited on all Medical and Scientific subjects, and also Reports of Cases occurring in practice. Advertisements inserted on the most liberal terms. All Letters and Communications to be addressed to the "Editor Canada Lancet,” Toronto. N.B.; GEO. STREET & Co., 30 Cornhill, London, Eng.; M. H. MAHLER, 16 Rue de la Grange Bateliere, Paris. TORONTO, DECEMBER 1, 1879. We would most respectfully call the attention of Canadian manufacturers of pharmaceutical preparations, surgical instruments and appliances to the advantages of advertising in the CANADA LANCET. The success of the LANCET has been without a parallel in Canadian medical journalism. Its present monthly circulation ranges from 2000 to 3000, and on the subscription list will be found the names of the leading physicians of every Province in the Dominion, from Prince Edward's Island to British Columbia. It is to be regretted that so few of our wholesale manufacturing chemists, and in strument makers avail themselves of the advantages of advertising. The American Houses have been systematically advertising in the LANCET for several years past, and are establishing their names as great manufacturers, and not unfrequently advertising some of our manufacturers as their agents. We beg most respectfully to call attention to these facts, and would say that we have decided, if the Canadian manufacturers will accept our proposition, to make a reduction of 20 per cent. from our regular rates in their favor, with the view of encourag ing greater efforts in the way of advertising. Our pages are well filled with advertisements of different firms, all of whom pay for the space they occupy. We are, therefore, not pressing for advertisements, but would like to see our own Canadian houses taking their share of the benefits which advertising in a judicious manner may offer. PUERPERAL MORTALITY IN HOSPITALS. "Taking as his basis the figures obtained in the hospital of Lariboisiere, for the years 1854 to 1878, and in the hospital Cochin for 1873 to 1877, M. Ist. Deaths from accidental causes; 2nd. From puerperal causes, consecutive on complicated labours; 3rd. From puerperal causes consecutive on simple labours. In the first year of the Lariboisiere, this hospital, quite new, and constructed in the most perfect manner, in accord with the precepts of hygiene, gave a return of mortality of one woman in every 11.8 delivered-horrible figures, which have not been equalled in any succeeding year in that ward, in the same rooms; the proportion from 1874 to 1878 has much decreased. It certainly cannot be admitted that the nosocomial, (that is, overcrowding of sick) influence had reached its maximum in a completely new hospital; it appears, then, that the congregating of a certain number of parturients in a limited space, and an atmosphere polluted by the accumulation, are not the sole causes of the mortality of lying-in hospitals. This mortality results from various factors, among which the social classification of patients plays a chief part. In order to reduce as much as possible the mor tality of parturients in his clinique of Lariboisiere, M. Liverly employs and recommends an exquisite cleanliness, as well as hygienic precautions both numerous and necessary; the result has been that the puerperal mortality has notably descended, and the figures cited by Mr. Beurman show that resiThe mortality has descended to one in 145, in dence in the hospital has ceased to be pernicious. 1877, and one in 155, in 1878, in simple labours. These figures closely approximate those obtained in the general population, and it may be hoped that they will yet improve. In the wards of the Maternité de Cochin, isolated almost completely from the rest of the hospital, and served by a special staff, M. Polaillon has obtained from 1873 to 1877 even better results, so that without it being understood that an hospital is a place favourable to parturients, it may yet be |