the abdomen the following morning for the purpose of taking away the remainder.

is to pour two drachms of the bromide of ethyl on a small napkin folded up to a space of about four inches square, and then laid on a larger napkin, folded so as to be large enough to cover the entire face of the patient. It is well to secure the two napkins together with a pin. The vapor of the bromide of ethyl is not inflammable; indeed, when dense, it extinguishes a flame if brought into contact with it. In this respect it is free from the danger incident to ether when administered at night in proximity to lights, or when the actual cautery is used. The article used by me was made by the firm of Powers & Wightman, manufacturing chemists, of this city."-West. Lancet.

To Dr. Lawrence Turnbull is due the credit of introducing this anesthetic, which for rapidity of November 1, present Drs. B., Steele, Moore and action and quickness of recovering from its effects Jackson. The air of the room in which the has claims to superiority over other agents for pro patient lay was saturated with carbolic spray, and ducing insensibility to pain. Dr. R. J. Levis, of the temperature raised to about 78°. The patient Philadelphia, finds much to recommend in it. was etherized, and an incision made by Dr. B. in finds that it produces but slight disturbance of the the median line about 4 in. long, midway between circulation, rendering the danger of syncope very the umbilicus and pubes. This was deepened small. Complete anæsthesia is produced by brountil there came into view a dark-red, congested mide of ethyl in from two to three minutes. Afterbody which resembled a fibro-cyst of the uterus.nausea is infrequent. "My own plan, with adults, It seemed adherent to the abdominal wall, but the operator, believing he had not yet penetrated the peritoneum, made an incision into it about an inch long, giving exit to a large quantity of gas and partly digested food, having a disagreeable, rancid | and sour odor. Among the escaping substances could be discerned pieces of meat, potato, rice, the entire pulp and seeds of grapes, etc. The incision in the abdominal wall was now carried about three inches above and to the right of the umbilicus. The opening in the cyst-like body was also enlarged upwards to about four inches. This permitted the contents to escape more freely, which they did to the amount of six or eight quarts, obscuring, for the time being, all the anatomical relations of the parts. They were received into a tub placed by the side of the table, and when they were sufficiently cleared away from the abdomen to permit a proper examination, it was discovered that the I think that this woman told me that she suffered latter incision-as well as the trocar puncture—had from falling of the womb; but however that may been made into the wall of an enormously dilated be, she is certainly a very nervous woman—almost stomach, along its anterior border between the hysterical-so much so that she cannot answer any lesser and greater curvature. The stomach was of my questions. I try to calm her by holding now drawn forward and a stream of warm car- her hand firmly, and endeavor to divert her attenbolized water thrown into it, cleansing it thorough- tion by feeling her pulse. You will find this somely. The operator then passed his hand into its in- times a very excellent means of quieting these hyterior and stated that he could discover no obstruc-sterical patients. Her hysterical aphonia is very tion or thickening about the pylorus. The part was not examined by anyone else. The uterus and ovaries were normal. During the operation the patient's pulse became extremely rapid and feeble, and it was found necessary to administer several hypodermic injections of brandy in order to keep her from sinking. The unfortunate woman expired about midnignt.

At the autopsy, the cavity of the abomen was found to be occupied by an immense cyst, which proved to be the stomach filling up the entire space in front of the other abdominal organs. When opened it was found to contain three or four quarts of very dark fluid; the pyloric orifice was contracted to the size of a crow-quill and the tissue about it infiltrated with scirrhus deposits.

[Comment is wholly unnecessary, nothing but the grossest carelessness, or an utter inability to interpret the clinical features of the case could have led to such a fatal blunder.]—ED. LANCET.

BROMIDE OF ETHYL.-THE NEW ANESTHETIC.

THE TREATMENT OF HYSTERICS.

marked, but I gather, from her sobbing utterances between the spasms, that she is 34 years of age and unmarried. This hysterical contraction of one or all of the sphincters of the body is a very strange thing for us to understand, but we very often meet with it. Now it is a spasm of the sphincter ani, with difficulty in defecation; again it turns up as dysuria, with scalding sensations in the passage of the urine, due to contraction of the muscular fibres throughout the whole length of the urethral track; or we may have spasm of the internal os uteri; or, as in this instance, of the epiglottis and trachea.

I introduce my hand into the vagina, and find a virgin os, long, sickle-shaped, and looking upward and forward, instead of downward and backward. But the examination gives rise to so much pain and such hysterical symptoms that I shall postpone it until after the lecture is ended. Meanwhile, let me say a few words to you regarding hysteria and its treatment.

Hysteria is a disease to which every woman is

liable; and which, every physician will be, some time or other, called upon to treat. Most of you will find it very hard, in most instances, to distinguish between hysteria and organic disease, for it, in many instances, mimics exactly grave structural diseases. There is no difficulty in forming a diagnosis when you meet with a real hysterical attack, attended with screaming and groaning and kicking.

When you are called to treat a young girl with a hysterical attack, there are three things which you had better do. (1) Institute at once firm pressure in the neighborhood of both ovaries. This is very apt to quiet the patient at once. (2) Administer an emetic. I have found that a woman who is well under the action of an emetic has not the opportunity to do anything else than be thoroughly nauseated. Give a full dose of ipecac with one grain of tartar emetic. (3) And this method of controlling the spasm will often act charmingly take a good sized lump of ice, and press it right down upon the nape of the neck. This produces quiet by its powerful impression upon the nervous system.

When the attack is entirely under control, the best method of preventing the occurence of another attack is to administer a full dose of assafoetidanone of your small, two or three grain doses, but ten grains all at once.

The Bill was brought in by Lord George Hamilton, and read a first time, on Tuesday, the 10th, and it stood for the second reading in the orders of the day on the 11th. But it has got no further. Ireland and Her Majesty's faithful Opposition have delayed the progress of business in the House of Commons so effectually that the Address in reply to the Queen's Speech has not yet been got rid of. Dr. Lush's Medical Bill has been read a second time; but it stood first on the orders of the day on Wednesday, and was not opposed, so that there was time for it to be read before six o'clock. But Mr. Plunket had given notice of an amendment to the other Medical Bill, and the Irish Volunteer Corps Bill stood before it in the orders. Mr. Mills' Medical Act Amendment Bill has also been introduced, and Mr. Errington's Bill to amend the law relating to the Qualifications required for holding certain Medical Appointments is to be brought forward. The Lord Advocate has introduced an "Artisans and Labourers' Dwellings Improvement (Scotland)" Bill; and several other measures in which the medical profession will feel a special interest have been, or are to be, introduced.— Med. Times and Gazette.

SURGICAL STATISTICS WITH AND WITHOUT LISTERISM.-The statistics given by Mr. Lister of the results from his operations performed under strict I am in the habit of regarding a hysterical antiseptic precautions, have called forth a reply woman in the same light as a skittish, unmanage- from the pen of Mr. James Spence, of Edinburgh. able horse; and just as I catch the one by means Mr. Lister took a period of five and three-quarter of a handful of oats, so I do not hesitate to en- years, during the period when he says his antiseptic trap the woman by much the same means. I re-system has been more perfectly carried out. Durmember one instance, in which I assured the husband of a hysterical woman that the drug I was giving-assafoetida-had a very powerful odor and had come from a very great distance. I have no doubt that he thought I had sent all the way to the Orient after it, and gave his wife to understand accordingly; certainly, my words acted like a charm in that case.

There is everything in a doctor's manner in the sick room; and he who looks and speaks hopefully, saying, "take this, and you will get well," and "do that, and you will feel better the next moment," is much more likely to cure his patient than the man who magisterially goes through the motions, without a ray of light or hope in his face, ordering "this pill to be taken in half an hour," and "so many teaspoonfuls of that prescription to be given at such and such times."-Dr. Wm. Goodell, in Clinical News.

MEDICAL AND SANITARY LEGISLATION.-The Government this year introduced their Medical Act Amendment Bill into the House of Commons at once, in order that it might, without delay, be referred to the Select Committee on the Medical Bills, which Committee was to be reappointed.

ing that time he had performed eighty major am-
putations, with nine deaths. Claiming the same
right, Mr. Spence takes a period before the anti-
septic system was heard of, when he used the very
simplest dressings. He finds that out of sixty-three
major amputations he had three deaths; during
the same period, out of twenty-three excisions there
was but one death. Mr. Spence objects to Mr.
Lister's elimination of fatal cases, by which means
the claim is made that "no patient died from a
preventable disease;" and he reminds Mr. Lister
of a fatal case of amputation at the shoulder-joint,
of which no mention had been made. Mr. Lister's
experience in ununited fractures of the femur is
thought to be unusually extensive, for during a
much longer period Mr. Spence has met with but
two such cases, and one of these was rather a case
of delayed union than non-union.
Both were ope-
rated upon successfully, and without giving rise to
constitutional symptoms. According to Mr. Spence,
Mr. Lister does not state clearly the results of his
operations as regards union, but Mr. Spence knows
of one case in which the operation was repeated
once or twice without union resulting. Of the re-
section of bones during acute necrosis, Mr. Lister
gives no examples; in this class of cases Mr.

Spence has been uniformly successful, and no spray or special antiseptic method has been used. Nor does Mr. Lister give his results in excision of tumors, although Mr. Spence claims that the large cut surface exposed to the air during these operations render this class of cases, according to the germ theory, especially liable to infection; in Mr. Spence's experience it is the exception for these cases not to do well. In regard to the application of the antiseptic system to chronic abscesses, Mr. Lister is asked to explain the fact that when he left the Edinburgh Infirmary there remained in his wards, uncured, some seventeen of these cases. Mr. Spence found in his experience that, as regards constitutional symptoms, these cases did well under the antiseptic system, but not as to cure or arrest of discharge.-The British Medical Journal, Jan. 24, 1880. Med. Record.

PROOF OF DEATH.-Those timid beings who are haunted by apprehensions of being buried alive, and who make testamentary provisions against such a contingency, may now take courage, for science has supplied an infallible means of determining whether or not the vital spark has quitted the mortal frame. Electricity enables us to distinguish with absolute certainty between life and death; for two or three hours after the stoppage of the heart, the whole of the muscles of the body have completely lost their electric excitability. When stimulated by electricity they no longer contract. If, then, when Faradism is applied to the muscles of the limbs and trunk, say five or six hours after supposed death, there be no contractile response, it may be certified with certainty that death has taken place, for no faint, nor trance, nor coma, however deep, can prevent the manifestation of electric muscular contractility. Here there is no possibility of mistake, as there certainly was when the old tests were employed. Muscular contractility under the Faradic stimulus disappears gradually after death. It is instantly diminished, but only finally extinguished in about three hours; and hence Dr. Hughes Bennett has suggested that electricity may sometimes be of use in medico-legal investigations, by affording evidence as to the time of death.Med. News and Circular.

SIMS' SPECULUM ALWAYS AT HAND.-The index and middle fingers of the right hand may be used as a perineal retractor in place of the ordinary Sims' speculum. They may be introduced with the patient in Sims' latero-prone position, the operator standing back of the patient, on the side of the table, in exactly the position of the assistant, who holds the speculum in the ordinary way. In this manner the cervix and vagina may be exposed almost as well as by the speculum. This method of exposing the parts may be of great use when a speculum is needed and not accessible; in the ap

plication, for instance, of the tampon in sudden hemorrhage, or in consultations at a distance, when, for reasons not anticipated, it becomes necessary to examine the pelvic organs.-Chicago Med. Gaz.

TREATMENT OF DELIRIUM TREMENS.-Opium given in large and enormous doses, as was formerly the practice, was conclusively shown by Ware to be pernicious. Sleep is the desired object, but | narcosis is not a substitute therefor. It is hazardous to induce the latter. But an opiate, in small or moderate doses, is often useful. A quarter of a grain of the sulphate of morphia every four or six hours, or an equivalent of codeia or some other preparation, is the safe limitation as regards dose and intervals. Alcohol is relied on by many, but opposed by some on the ground of moral considerations. The latter are of little weight. The patient will not be likely to resume the habit which has caused the disease any the more, because alcohol may have conduced to the recovery. treatment, alcohol should be given in moderate quantity, and suspended when sleeping occurs. It is indicated especially when the patient is much enfeebled, and the pulse denotes cardiac weakness. The inhalation of chloroform may be tried, especially when the delusions induce extreme terror or violence of delirium. It sometimes is useful, but more frequently it fails. The attempt to produce anæsthesia is often resisted by the patient, and the violence of the delirium is thereby increased. The hydrate of chloral is more easily employed. sometimes acts like a charm. Proper precautions are to be observed in the use of this remedy. The bromides may be given with much less reserve They should be fairly tried. Their effect is sometimes excellent and sometimes nil. Digitalis is in some cases notably efficacious; it is indicated especially when the heart's action is frequent and weak. It is unnecessary to give this remedy in doses of from half an ounce to an ounce of the tincture, as may be done with safety; half an ounce of the infusion every two or three hours, will secure all the benefit to be obtained from it. Antimony is suited to a certain class of cases, namely, those in which the symptoms are violent, and the patient robust, and the action of the heart strong.-Flint's Clinical Medicine.

It

HOW TO APPLY THE HOT WATER VAGINAL DOUCHE.-In the Chicago Medical Gazette, Dr. E. C. Dudley says:

The following is designed to impress the importance of strict observance of detail in the application of the douche, since in no other manner will its good effects be realized: 1 It should invariably be given with the patient lying on the back, with the shoulders low, the knees drawn up and the hips elevated on a bed pan, so that the outlet of the vagina may be above every part of it. Then the

THE CANADA LANCET.

A Monthly Journal of Medical and Surgical Science

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TORONTO, APRIL 1, 1880.

TREATMENT OF ELEPHANTIASIS
BY ELECTRICITY.

The Gaceta Medica of Bahia, in its issue of October last, publishes a long and able article on the above subject, by Dr. Araujo, in which details are given of two cases treated by him with apparent success, by means of electric currents of induction, continued regularly over a period of twelve months. Both the patients were females, and their disease had been of long duration. A third case is detailed, which was presented in a male, but in this patient the scrotum was the part affected, instead of the leg, as in the females. Perhaps the most interesting fact stated by Dr. Araujo is, that he was led to the adoption of this treatment by electricity, on purely theoretic grounds. We here introduce a translation of Dr. Araujo's speculations on the etiology of the disease.

electricity, would necessarily be reflected in each arterial, venous and lymphatic capillary, and consequently call into action the torpified circulation? In this manner the obstructed lymphatic vessels should again become pervious, with the exception however, of those which had already completely lost the qualities of contractile tubes, and whose walls had suffered a degeneration which approached them from the histological constitution of the textures of the vicinity, that is to say, the lardaceous degeneration. Should electricity, however, fail to benefit the latter conditions, it certainly ought to be of service for those vessels which are simply dilated and not obstructed, in other words, for the lymph-angiectases. Starting from these premises, which I confess were merely theoretic, I resolved to employ the electric treatment on my patient."

Dr. Araujo draws special attention to the fact, that in his patients, discovery was made by a pro fessional friend, of the presence in the parts affected, of the filaria Wucheriri, in both the developed and the embryonal state, and he seems to regard the efficiency of the electric shocks on these creatures as an important element in his successful treatment. He enumerates the following facts, as deserving of consideration.

First, the coincidence in a single individual of divers morbid manifestations, which were attributed to microscopic filaria, as the efficient cause. Secondly, the discovery, by Dr. Victorino Pareira, of embryoes, in the liquid of lymph-angiectases,— a fact hitherto not observed in Bahia. Thirdly, the discovery by myself, of two large filaria in the liquid of the same procurement. Fourthly, the curative result obtained in relation to the associated chyluria, and erysipelas, and the improvement of the craw craw and the elephantiasis."

"Elephantiasis is, principally, a lymph-angiectasis; and the troubles under which my patient "the male" suffered, ought, to a great extent, to prove the existence of atony of the lymphatic vessels of the affected part. Histological postmortem examination has shown, that in elephantiasis there is obstruction of the lymphatics and their He asks," Will the flattering condition" into respective lacunæ, from agglomeration of enlarged which the electric treatment has brought his patient, and deformed epithelial cells. This heaping of "prove persistent?"-to which he discreetly recorpuscles, which here and there distend, and in plies, "time alone can tell." For the sake of every part fill the lymphatics of the region, clearly humanity, and the honor of Dr. Araujo, we denote that a primary paralytic condition has sincerely hope the answer given by time will be taken place. As regards the lymph-angiectases, satisfactory. He has not proceeded in his work, even the naked eye suffices to discover that such in a merely empirical manner, but with a rational, dilatations cannot exist without an atonic state of scientific consideration of the cases which came the walls of the respective lymphatics. Such being the case, is it not probable that a means which might cause contraction in the scrotal mass, say

under his observation and treatment. Though elephantiasis is a disease almost peculiar to southern climates, it is not unknown in northern