The death of Freeman J. Bumstead, M.D., LL.

than two drachms were administered when the face became pallid and breathing ceased. Every, D., of New York, is noticed in our exchanges. means was used to resuscitate the patient, but without avail. No blame was attached to the physicians in charge.

JOHNSTON'S FLUID BEEF.-This fluid Beef is essentially an extract of beef prepared on the most scientific principles, and containing all the elements of flesh food in a concentrated form. In its manufacture the albumen and fibrin, or rather the entire lean of beef, are by a special process desiccated and mechanically pulverized to such an extent as to be almost imperceptible in water. It is not only adınirably adapted to the wants of the invalid, but is also useful as a ready-to-hand food, for the more robust and vigorous. The British Government gave a large order for this preparation of fluid beef, for use in the army during the recent Zulu war. We have no hesitation in recommending it as a most excellent nutriment for both invalids and convalescents.

MEDICAL ELECTIONS.-Dr. J. L. Bray, of Chatham, is a candidate for the representation of the Western and St. Clair Division in the Medical Council of Ontario. The Dr. is an advocate of increased territorial representation, and the appointment of a medical examining board from members of the profession outside the council. In his opinion there should be two representatives for each division, and he also thinks the fees charged to students should be lessened if possible. We hope to see the Dr. elected for this division.

Prof. Meigs, of Philadelphia, has also paid the last debt of nature quite recently.

The groups

ROGERS' GROUPS OF STATUARY. of statuary manufactured by Mr. Rodgers, Union Square, New York, are unique and universally ad

JOURNALISTIC.-The Medical News and Library and the Monthly Abstract, have been consolidated mired. They are made of a clay-like material, and into one monthly journal-The Medical News and are unexcelled for life-like expression, and correctAbstract. Dr. J. B. Hunter has resigned the edi-ness of symmetery. The accompanying cut, "The torship of the N. Y. Medical Journal, and has Balcony," represents one of his latest productions, been succeeded by F. P. Foster of New York. A which for beauty of conception and artistic finish, The height of this group is 32 new bi-weekly Journal, The Chicago Medical Gaz- stands unrivalled. ette, edited by Dr. E. C. Dudley, has recently been inches and width of base 15. The lady in the issued. It presents a very creditable appearance. Balcony is holding her little boy who is dropping a piece of money into the hat of one of the street musicians below, while the girl with the tambourine is making the dog sit up and balance something on his nose. One of his groups would make a most suitable Christmas present, and a handsome ornament for a parlour, library, or office. Send for catalogue and price list.

BRITISH QUALIFICATIONS.-The following gentlemen from Canada have satisfactorily passed the professional examination of the Royal College of Surgeons, Eng., and were admitted members of the college-Drs. C. R. McLean, J. C. C. Cleaver, J. B. Lawford, and W. H. Henderson.

Books and Lamphlets.

DISEASES OF WOMEN-By Lawson Tait, F.R.C.S., Surgeon to the Birmingham Hospital for Women, and Consulting Surgeon to the West Bromwich Hospital, etc., etc. Second edition revised and enlarged. New York: Wm. Wood & Co. Toronto: Willing & Williamson.

This is another of the valuable series of reprints of Wood's Library publications, which we have perused with very high satisfaction. The book is presented on unusually strong paper, and in very clear type, covering only 185 pages of the usual size of these publications. It is not saying too much in its commendation, when we venture the opinion, that it contains more solid instruction, conveyed in clear and decided terms, than any work of double its size on the same subject, which we have yet met with.

condition of examination, however, should never be entered upon without the presence of a third person, and this is the use of an anesthetic; for even in the minds of the purest women, there can be no doubt that delusions occur during the anæsthetic condition which retain strong hold of their waking moments. Any man, therefore, who administers an anesthetic to a woman, alone, is like the priest who hears confessions in his study-he deserves any trouble he may get into, either for his folly or his crime."

This is very hard language, but it is both honest and wise, and it may be profitable to both the young and the old to bear it constantly in memory."

Here is another little excerpt which may be commended to careful consideration, for it is to be feared that it is even more called for in this country than in England.

"Armed with the caustic stick, the inexperienced practitioner is apt to think he can cope with all uterine maladies; and very numerous are the cases in which I have seen irretrievable mischief

simple chronic inflammation transformed into a
serious acute form by the injudicious use of
nitrate of silver; and over and over again I have
had to reopen the uterine canal, when it had been
occluded by repeated applications. It is con-
stantly forgotten that solid nitrate of silver is an
escharotic, and that every time it is applied
cess of sloughing, followed by cicatricial contrac-
tion, is induced."

pro

During the process of reading we had marked for presentation to our readers, as illustrations of the merits of the book, various passages which we considered indicative of superior ability, and advanced gynecological science, but we have ulti-done by this potent remedy. I have seen a very mately found these so numerous, that without doing injustice to the author, we could not make discriminant selections. Nothing, however, will more command the approbation,-if indeed we might not say the admiration of the readers-than the candour and courage with which Dr. Tait confesses his own past errors and failures, which we are half tempted to designate as a new departure in the specialty of gynecology. If all the aspirants to fame in this branch of surgical art, were to pub- The book abounds in similar valuable admonilish full details of their fatal issues, and largely to tions, which will be regarded by the experienced curtail the records of their successes, they would confer on our profession, as well as on the vital as judicious and noteworthy, and should be well considered by all beginners. interests of society, a most valuable service. A coast chart, studded with marks of wrecks, is safer to the navigator than one which displays no such admonitors of perilous waters; and we cannot but regard every medical writer, who faithfully and frankly details his own errors and misfortunes, as an eminent and most praiseworthy benefactor, alike to science and to humanity.

Though we have said that we dare not venture on "discriminant selections," we cannot resist the temptation of presenting the following most sagacious admonition on the subject of gynecological examinations with the aid of anesthesia: "One

A SYSTEM OF MIDWIFERY, by Wm. Leishman, M. D., Reg. Prof. of Midwifery, University of Glasgow. Third edition; revised; with 205 illustrations. Philadelphia: H. C. Lea. Toronto: Hart & Rawlinson.

We gladly welcome the new edition of this excellent text book of midwifery. The former editions have been most favorably received by the profession on both sides of the Atlantic. In the preparation of the present edition the author has made such alterations as the progress of obstetrical science seems to require, and we cannot but admire

the ability with which the task has been performed. pocket they are always convenient for making entries of visits, advice, &c., which might otherwise be neglected, and thus save their price many times over in the course of a year.

We consider it an admirable text book for students during their attendance upon lectures and have great pleasure in recommending it. As an exponent of the midwifery of the present day it has no superior in the English language.

MEMORIAL ORATION IN HONOR OF E. MCDOWELL, the father of Ovariotomy. By S. D. Gross, M. D., L.L.D., &c. Philadelphia: Lindsay & Blakiston.

APPOINTMENTS.-Dr. J. A. Grant, of Ottawa, has been appointed consulting physician to the General Catholic Hospital vice Dr. Hill, retired; and Dr. Prevost has been appointed a member of the acting staff. Dr. Hill on the occasion of his redress by his confreres, and was subsequently ap tirement was presented with a complimentary adpointed an honorary member of the consulting staff of the Hospital. He has been a member of the staff for almost a quarter of a century. TEXT BOOK OF PHYSIOLOGY. By M. Foster, M.A., Kannon, of Bishop's College, Montreal, has been M.D., F.R.S., Cambridge. Third edition; re-appointed house surgeon to St. Peter's Hospital, vised. London: McMillan & Co. Toronto: Albany, N.Y. Hon. Dr. Paquet, of St. Cuthbert, Willing & Williamson.

This work is in the author's happiest style, is well gotten up, and contains an engraving of McDowell and also of the monument erected to his memory in Danville, Ky.

Dr.

Walker, M.D., of St. John, N.B., has been appointed one of the visiting physicians of the General Hospital. Dr. Spencer, a Canadian graduate, has been appointed professor of chemistry in King's College, Halifax.

Que., has been appointed Prof. of Hygiene in VicIt is only a short time since we reviewed the sectoria College Medical Faculty, Montreal. Thos. ond edition, and we have little to add to the opinion we then expressed in reference to the scientific character of the work. In fact this is almost an objection to the work for general use. Few have either the time or opportunity to work out the experiments and problems which it contains. The author is aware of this fact, however, and has preREMOVALS. Dr. Hutchison, of Fordwich, has pared a cheap "Students' Edition," which the pub-removed to Meaford; and Dr. McKelvy, of Ethel, lishers state will be ready in a short time. The has taken his place and practice.

principal changes in the present edition have reference to the physiology of muscle and nerve, which the author has made more easy for the general

reader.

CORONERS.-W. P. Buckley, M.D., of Prescott, Ont., has been appointed Associate Coroner for

the united counties of Leeds and Grenville.

T. S. T. Smellie, M.D., of Prince Arthur's Land

THE PHYSICIAN'S HAND-BOOK for 1880 by Drs. ing, has been appointed Coroner for the district W. & A. D. Elmer. Price $1.75. of Thunder Bay.

THE CANADA LANCET,

A MONTHLY JOURNAL OF

MEDICAL AND SURGICAL SCIENCE.

VOL. XII. TORONTO, FEB. IST, 1880.

Original Communications.

FIBROID TUMORS OF THE

THEIR DIAGNOSIS AND TREATMENT. BY F. CATTERMOLE, M.D., L.M. B., L.S.A.P., LONDON, O.

these symptoms are developed long before the growth has attained large dimensions, and but too often do these symptoms become alone the sole objects of treatment, to the entire neglect of their fons et origo, id est, the still increasing overgrowth of unstriped muscular fibre, mixed up with connective tissue, which, notwithstanding its feeble No. 6. vitality, manifests its existence by most unmistaka ble signs For the relief of this condition, palliatives, as a matter of necessity, are first employed, via oris, and in the form of injections, with the UTERUS._general effect of lessening the amount of the discharges, and perhaps staying them, for a time, but without additional and more potent local measures, they will recur again and again, to the disappointment and disgust of both doctor and patient. The former, I think, will hesitate no longer as to the necessity of a thorough examination, per speculum, sound, and double palpation, in order to obtain a perfect diagnosis, being well aware that there are other affections of the womb with symptoms more or less resembling those of fibroid, such, for instance, as corroding ulcer of the os and cervix, a granular condition of the mucous membrane of the uterine cavity, simple fungoid growths, and tubercle of the womb, also some uterine displacements. The cervix and inner os must be fully dilated with laminaria, even risking septicemia, the great bug-bear of timid practitioners, and the mucous surface of the entire cavity well examined with the finger, and should abnormal growth be detected, the most appropriate treatment at once determined on.

If the assertion of an eminent gynecologist be correct, that twenty of every hundred women are subject to fibroid tumors of the uterus, or even should his estimate be overdrawn, it behooves the members of the healing art to search out a more prompt and radical method of treatment than has been hitherto generally adopted for the arrest and cure of this much too common and lingering malady. It may be urged that our text-books are sufficiently profuse on the subject, and give a large amount of practical treatment, and they certainly do so, as far as regards the advanced stages of the disease, but render little or no information as to remedial measures adapted to its early stages, or just when it is most vulnerable and amenable to safe and efficient treatment.

If the overgrowth be inconsiderable, and of limited extent, it may be lightly scarified and swabbed with fuming nitric acid, and the vagina plugged lightly with cotton wool, for twenty-four hours. After this, the acid should be applied, through a glass tube, about every seventh or eighth day, until six or eight applications shall have been When the uterine canal is moderately made.

It is at least humiliating to contemplate the number of cases that drag on year after year, in which tumors attain an enormous size, that by timely and active treatment, might be destroyed during their early growth. The existence of this abnormal growth in the uterine parenchyma, (sometimes excepting the subperitoneal cavity), very soon developes a troublesome train of symptoms, quite sufficiently demonstrative of its presence, more especially if the hyperplasia be sub-mucous patulous, the small glass tubes can be generally or interstitial, and nearer to the mucous membrane passed to the fundus without previous dilatation than to the peritoneum. Hemorrhage, in some by tent. form, is its most prominent symptom, usually commencing with excessive menstruation, followed by metrorrhagia, inter-periodic hemorrhage, leucorrhoea, and occasionally displacement of the womb, with irritability of the bladder and rectum. Very generally, some or the greater number of deemed necessary-the patient observing the

Mild cases will generally succumb to the measures above stated. Should, however, the tumefaction have assumed larger dimensions, rather more formidable treatment will be required, and a week or ten days preparatory treatment may be

some instances, rather more pain or greater uneasiness is experienced than results from the use of nitric acid, the womb bearing the latter better than any other effective escharotic.

The amount of success following the above plan of treatment of fibroid, in its early stages, I consider, fully warrants me in saying that if it be carefully and adroitly carried out, that success in the greater nuinber of cases will be the result.

Some few practitioners of acknowledged ability have seemed to pin their faith on several internal remedies, among which are bichloride of mercury, bromide of potassium, chloride of calcium, biniodide of mercury, and ergot, the last being about the only medical remedy entitled to any consideration in the treatment of fibroid, and that more especially from its well-known influence on the uterine muscular fibre, its power of lessening the calibre of the arteries of the uterine parenchyma, thereby diminishing the nutritive supply to the abnormal growth. This remedy may possibly

recumbent position the greater part of the time. It may be as well not to inform the patient of the necessary future proceedings, or she may demur, and request her attendant to continue his medicines and injections, but if he values his professional reputation, he will not indulge in mere placebo treatment, or even too long in the use of the best palliatives, but as soon as his patient is in a fit condition, let the cervical canal and inner os be fully dilated with long and large laminaria. In some cases this procedure will require two days for its completion. I usually have the chloroform administered just before taking away the tents, and immediately on their withdrawa', hook long, slender vulsella or tenacula firmly into the lower part of the cervix, on either side, and carefully draw down the external os as near to the labia pudendi as possible. If this is done slowly and without jerking, it may be accomplished with safety, more especially if an assistant renders aid by moderate external pressure. The finger may now be passed on the mucous merit some of the praise so liberally heaped upon surface as high as the fundus, thus measuring each it by its eminent advocates. In the advanced bulging part, which should be incised and punc-forms of the disease, as an auxiliary it may be tured with a long, slender, sharp-pointed knife, serviceable, in aiding the expulsion of the tumor, guarded, if necessary, with thin lint or rag. On and even in its early stages, in checking hemorwithdrawing the knife, incise the inner os in two rhage, but on the whole it cannot be regarded as or three places, and divide the cervix on both a reliable remedy for the dispersion of this malady, Allow the parts to bleed freely, if they will, for whether administered per os or hypodermically, provided the condition of the patient will bear it. it has almost invariably to give place to the more As soon as the bleeding has sufficiently subsided, efficient plan of local treatment. I swab the incised and punctured parts freely with Judging from a case reported by Dr. Byford, fuming nitric acid, and also the divided edges of the free, hypodermic use of the drug is not altothe cervix, plug the vagina with a tampon of gether without risk, for in his case it caused cotton wool, and administer a full opiate. About necrosis of the tumor, the fragments of which seven days after this, I usually repeat the swabbing were extruded. He also states that on two occawith acid, carefully passed through the glass canu- sions peritonitis occurred from the violent contracla, and continue the application for a period of tions of the womb, one of which proved fatal. two months, or longer if deemed necessary. Similar results have been reported by other practitioners.

In a few cases, in which the tumefaction was not quite sensibly reduced, after three or four Before leaving this subject, may I ask your applications of the nitric acid, I substituted for it opinion as to the probability of extirpation of the the acid nitrate of mercury-in almost every case ovaries ever becoming the accepted operation for with excellent effect-four to seven applications of the relief or cure of uterine fibroid, for this the last named remedy are generally sufficient to is one among the surgical remedies that have been reduce the abnormal enlargement. In some con- employed for this purpose during the last five or stitutions, salivation is quickly produced by the six years. Dr. Goodall states that out of fifty-one acid nitrate, therefore its action in every case must abdominal section, and twenty by the vaginal, operations, thirty-one have been done by the be watched. No accident of the sort has occurred attended in the latter by four deaths only, and in in any of the cases in which I have used it. In the former by cleven.