In the present century English law has had to deal with many female poisoners, among the more noted of whom were Mary Ann Burdock, who was executed in 1835 for the poisoning, by arsenic, of Clara Ann Smith; Sarah Chesham, a wholesale poisoner, who was at various times tried for the crime of poisoning first a child, then two of her own children, and finally her own husband. Her conviction was secured by the confessions of an accomplice. Constance Wilson, another wholesale poisoner, was executed in 1862.

The case of the notorious Madame Lafarge, in France, is of interest as showing how doctors disagree. Madame Lafarge was tried for the murder of her husband, by arsenic, administered in cake and fowl. On September 9, 1840, the chemists reported that no traces of poison were found, but five days later, Orfila and other experts declared that poison was to be found “in every part of the body submitted to them." The prisoner was found guilty, "with extenuating circumstances," and sentenced to hard labor for life.

The case of Madeleine Smith, upon which was founded Wilkie Collins' story, "The Law and the Lady," excited the deepest interest on two continents, but in this case, though there was abundant proof that her victim died of arsenical poisoning, the artifices of lawyers procured a verdict of "not proven."

"DR." L. F. Pond, a "cancer curer," entered Aurora under a shower of advertising circulars in which his great skill was depicted. He became a prominent local light in religious circles, and succeeded in establishing a "cancer" hospital. He has just been convicted by a church trial of lying, swearing and taking advantage of dying patients. A few more cases of this kind will probably teach religious bodies that men who violate the ethics of their own profession are not too scrupulous in their views of ordinary morals.

ASSOCIATE JUSTICE GAINES, of the Texas Supreme Court, rendered a decision adverse to the claims of Dr. J. B. Fears for payment of fees for autopsies, on the ground that the law made no provision for such payment. Judge Gaines said in mitigation of the seeming harshness of his decision :

"A postmortem examination at a coroner's inquest is frequently necessary for the detection and punishment of crime. It does not seem just to impose this duty without compensation upon a learned and enlightened profession, whose custom is not to refuse the calls of charity. But they must look to the legislature for relief. We can only declare the law as we find it, and

as it now stands we think there is no provision for their compensation. We do not decide that they can be compelled to perform these services, for that question is not presented by the facts of this case."

In equity the claim of Fears was just, according to this decision. Physicians can under it easily secure compensation for autopsies by refusing to make them without it.

THE microbe of senility seems to have entered the brain which conducts the weekly "Medical Review," for it says, anent the MEDICAL STANDARD'S remarks on the St. Louis surgical pun epidemic: "The pained and anxious expression of the dog being compelled to listen to surgical puns will not be a circumstance to that presented by the average Chicagoan, when Congress gently, but firmly informs him that St. Louis gets the fair.”

THE MEDICAL STANDARD, some years ago, in discussing hypnotism said: "A note of warning should be sounded. It has been satisfactorily shown that no healthy person with a well developed nervous system can be hypnotized, those who can have either an illy balanced or diseased nervous system. Frequent hypnotism of the lower animals results in paralyses and other neuroses. Hypnotism in them as in man depends on a nutritive shock to the nerve centers of control, and hence is attended by sudden blood changes with the usual concomitant evils. Hypnotisin therefore becomes a satisfactory therapeutic agent as its certain dangers more than equal its possible benefits." The "Therapeutic Gazette," at this time, much biased by the influence of Luys, defended the practice. Lately, however, under the influence of Meynert, it is beginning to repeat the very necessary warning of the MEDICAL STANDARD as to the dangers of hypnotism.

SPERMIN, a leucomaine, is the essential element in producing an exhilarant effect which may be due to the Brown-Sequard injection according to the "Medical Age," which very rashly leaves the influence of the imagination out of consideration.

THERAPEUTICS AND PHARMA

COLOGY.

POT. BROMIDE IN EPILEPSY.-Dr. Puskulieff ("Mediz. Spiss.") finds that Potassium bromide aggravates the mental symptoms of epilepsy.

PILOCARPINE, according to Cirera (“Gac. Med. Cat."), is a stimulant of uterine muscular tissue under the conditions present at the outset of labor.

PROLONGED SLEEP AND CHOREA.-Drs. Gairdner and Bastian claim that prolonged sleep produced by chloral hydrate exercises a beneficial effect on chorea.

CANTHARIDES IN LEUCORRHŒA.- -Dr. Parvin advises the use of five minim doses of cantharides t. i. d., gradually increased to fifteen in the leucorrhoea, which vicarates for menstruation.

CHLORALAMIDE has been found by Peiper, Reichman, Hagen, Hüfler and Rabow to give excellent results as an hypnotic. It is a combination of chloral and foramide. The from fifteen to sixty grains.

dose is

SULPHONAL.-Dr. H. M. Field ("Therap. Gaz.") has had excellent results with this drug by the following procedure. He first orders fifteen grains for a night or two, then reduces the fifteen to ten, and if the soporific effect be sufficient, to seven or eight. A drug admitting of such reduction is not likely to form the basis of a habit.

CREOLIN, according to the "Western Druggist", is a mixture of hydrocarbons (petroleums) with higher boiling phenols with some pyridin basis, resin soap and water. It seems to vary in the proportion of carbolic acid it contains, and an equally effective preparation could no doubt be prepared from a mixture of coal tar, crude carbolic acid and common washing soap. COUGH MIXTURE FOR CHILDREN.-The following is recommended by the "Western Druggist" for children, as being colorless: R Ammonium bromide,

Ammonium hydrochlorate,

each......

.dram I.

Orange flower water dilute. .fl. oz. 1.
Syrup dextrin (glucose)

enough to make..... fl. oz. 3. Dose-One-half to 1 teaspoonful.

IODOFORM AS A HEMOSTATIC.-Dr. Michailoff ("The Satellite") advocates the use of iodoform as a hæmostatic. He claims good re

sults in hæmoptysis, metrorrhagia, hæmaturia, and hæmorrhoidal bleeding. He gives it in all cases of hæmoptysis with Dover's powder, five times a day. It is combined sometimes with tannin, and in hæmaturia he uses it in conjunction with soda bicarbonate.

RADAM'S MICROBE KILLER has been examined by Dr. Eccles ("Western Druggist") who finds the "killer" to be composed of: Oil vitriol, drams 4; muriatic acid, dram 1; red wine, (about) ounce 1; well or spring water, gallon 1. This is the scientific compound lately advertised in the "North American Practitioner" as a cure for cancer, consumption and other instances of "secondary mixed infection."

IPECACUANHA IN INSECT BITES. Dr. Neal ("Med. Age") recommends the use of ipecacuanha in all cases of insect bites, and states that recently a patient traversed India bidding defiance to mosquito bites with the following application:

This is well worth knowing outside of India, and it has been stated that a tincture of insect

powder sponged on the surface is good for warding off flies; so also is oil of cedar.

"TRIONAL" AND "TETRONAL," contracted terms indicating respectively diethyland diethylsulphon-methyl-ethyl-methane and ("Western Drugsulphon-diethyl-methane,

gist") are suggested as possible substitutes for sulphonal; diethyl-sulphon-dimethylmethane. It has been found that these sulphur compounds are active as hypnotics in the proportion that the methyl groups are replaced by ethyl. Thus, whilst in sulphonal, two ethyl and two methyl groups are linked together, when one methyl group is replaced by one ethyl, a more active compound is produced, as is still more the case when both methyl groups are replaced by ethyl groups as in the last compound called tetronal. The compounds are very similar to sulphonal, but their solubility in water appears to decrease as the ethyl groups increase. They are freely soluble in alcohol, less in ether, and possess a bitter, camphoraceous taste.

COFFEE WITH LEMON IN DIARRHOEAS.Dr. S. Khristoff ("St. Louis Med. and Surg. Jour.") advises the use of lemon coffee in diarrhoea. There is taken internally, two or three

times a day, from one to three teaspoonfuls of ground burnt coffee thoroughly impregnated with the juice, and pulp expressed from several slices of a fresh lemon. Such "coffee and lemon gruel" stops diarrhoea and removes any abdominal pain and tenesmus rapidly (sometimes in 24 hours). The remedy is equally successful in adults and children above 10 years of age. Simultaneously rice water should be given to drink, and the patient's diet properly regulated. According to Dr. R. Neale's, "Medical Digest," coffee (in the shape of beverage probably) with lemon juice was recommended by Holsbeck in ague, while Druitt treated diarrhoea with lemon juice alone. Coffee was advised by Parves in typhoid fever and by Greenhalgh in vomiting. It is also said to prevent griping from the use of senna. Generally, both coffee and lemon are supposed to have some remedial value in gastrointestinal disturbances. Dr. Hughes (MEDICAL STANDARD) has recommended analogous uses of coffee.

SALICYLIC ACID IN TYPHOID FEVER.Dr. Schakovski ("Thera. Monatsh.") claims great success from the use of salicylic acid in malignant scarlatina. He has used it in one hundred and twenty-five cases. The mortality is but 3 per cent. The following formula was used:

M. Sig. Give a teaspoonful every hour during the day, and every two hours during the night.

The temperature falls very rapidly after taking this mixture, so that in certain cases, inside of forty-eight hours, the temperature has fallen from 105.8 F. to 100.4° F. All trace of fever vanishes by the tenth day. Nevertheless the author advises the continuance of the remedy for some time, in decreasing doses, to prevent a relapse. All serious complications, such as uræmia, anasarca, and diphtheria, are avoided through this treatment. The treatment is ineffectual only when employed too late (after the fourth day of the illness), or where grave complications already exist.

UNTOWARD EFFECTS OF QUININE.-Dr. A. D. Williams ("St. Louis Med. and Surg. Jour.") reports a case: Five grains were given a female patient who claimed to have once been nearly killed with quinine. She promptly went to sleep; but in about an hour she awoke with a most intense itching of the entire skin; even the skin of the external meati itched, and the mucous membrane of the mouth, throat and œsophagus itched. The intense desire to

scratch made her almost wild. Soon a papular eruption broke out on the skin, causing it to feel rough when the hand was passed over it. Very soon a most violent nervous chill set in and lasted 20 to 30 minutes. During its progress the shaking was so violent she could scarcely speak, on account of the quivering of the lower jaw. Even the bed joined in the shaking. So soon as the chill subsided a most violent headache set in, and a high fever followed, the temperature going up to 104°. The high fever continued for many hours. In the emergency Dr. Love was called in and administered sedatives, very properly. Later Dr. Frazer was called. Marked depression followed the chill, the patient being confined to the bed. On the second day she could barely sit up. Her mind remained clear all the time. Lewina ("Untoward Effects of Drugs") cites analogous cases.

OBSTETRICS AND PEDIATRICS.

MECHANISM OF THE THIRD STAGE OF LABOR. According to Dr. H. St. Clair Gray, of Glasgow ("Practice") the separation of the placenta is favored by tying the cord. In one hundred cases he tied the cord at once. The placenta was expelled spontaneously in ten minutes. In another one hundred cases the cord was cut with sharp scissiors and allowed to bleed. In all these cases the placenta had to be expressed. In this last series of cases little or no clot was found, while in the first series a post-placental clot was always present. This engorgement of the placenta resulted from tying the cord, therefore, played the most important part in the separation of the placenta, aided by the retraction of the placental site, by the ordinary contraction of the uterus.

LABOR IN OLD PRIMIPARA.-Dr. Ettore Truzzi of Milan, states ("Arch. de Tocol.") that among old primipara, contraction of the pelvis, plays a relatively important role in labor. The period of puberty is late. Menstrual disorders are frequent. The catamenial flow is rather scanty. Complications are more frequent than at an earlier period, which is due to functional and organic renal lesions. Very frequent interruption to pregnancy is noted, At labor rigidity of the lower segment and the neck of the uterus, added to insufficient uterine contractions, render expulsion difficult. The period of dilatation is habitually long. The soft tissues are predisposed to laceration, and renders the chances of post-partum convalescence less favorable. Eclampsia is relatively frequent. operative interference is required more often than in normal labors. There is the frequent

need of the forceps, most generally on account of simple uterus inertia or spasm of the inferior uterine segment. Presentations other than vertex are abnormally frequent, which may be entirely due to the rigid condition of the lower segment of the uterus.

The condition of the fœtus at the moment of expulsion, and the larger proportion of cases of intra-uterine asphyxia, are due to the frequent causes of dystocia. Since the introduction of antiseptic measures, the mortality remains much higher in old primiparæ, whether the pelvis be normal or distorted, but antisepsis has caused a great decrease in mortality among those with normal pelves.

UTERINE ASTHMA.-Dr. Peyer ("Berliner Klinik") claims that asthma is always neurotic, and often brought on by the excessive exercise of different functions. Coitus, in the case of two young married women, caused violent attacks of asthmatic sneezing. In another case the patient suffered from uterine fibroid, with severe asthma, which disappeared after the removal of the tumor. A patient subject to violent asthmatic fits, was cured on becoming pregnant for the first time. In another case, the patient suffered from chronic metritis. When the uterine affection was cured, the asthmatic complication disappeared. All of Dr. Peyer's cases occurred in more or less hysterical people, and in two there was a distinct family history of neuroses. Physicians should distinguish between the coincidence of true asthma and disease of the sextual functions and the type where the former is an effect of the latter.

INFANTILE DYSPEPSIA.-Dr. A, Jacobi ("Arch. of Pæd.") says, that as long as a baby is not nursed by a healthy woman, the opportunities for acquiring some kind of gastric disorder are very numerous indeed. Dyspepsia is therefore quite frequent. Its treatment consists in more or less abstinence, and in the regulation of diet. As the gastric contents of infants who have been brought up on artificial foods is liable to be very acid, alkalies in small doses and frequently administered, have a good effect. Bismuth may be added. When there is vomiting, it must be determined whether it is gastric, and from what cause. Those who have been in practice know too well how often they have seen meningitis taken for a gastric disorder, and how common is the occurrence of that symptom in the incipient stages of all kinds of inflammatory fevers. When all these and the local irritation of the stomach (brought on, for instance, by the presence of ascarides) and nephritis can be excluded, only then the vomiting ought to be con

123

sidered as gastric only. Now and then abstinence only, or the drinking of warm water, or warm mustard water, to facilitate vomiting; or alkalies, or alkalies with bismuth; or resorcin to disinfect the contents; or dilute hydrochloric acid to correct the nature of the gastric acid; or the washing out the stomach with warm water, or with an alkaline solution, or with a solution of one or two per cent. of resorcin in water; and, finally, after the stomach has been freed of injurious contents, small doses of opium (from one-hundredth to a fortieth of a grain every hour, or its equivalent in morphia or codeia) will prove satisfactory.

TURPENTINE IN CROUP.-Dr. Lewentauer ("Satellite") cites the following cases as illustrating the value of turpentine in croup :

Case I. A child, two years old, several days sick, brought to the hospital in a state of threatened asphyxia, on admission was seized with violent dyspnoea and a paroxysm of coughing; face livid; pulse almost imperceptible. M. Lewentauer administered at once a tablespoonful of spirits of turpentine; ice-compresses were placed around the throat. The following day the condition of the child was improved; the administration of a teaspoonful of turpentine caused the false membrane to be expectorated. entauer prescribed the following:

Olei terebinthinæ....
Olei amygdala dulc.

Syr. simplicis..
Mucil. acaciæ..
Vitelli ovi, No. i

Aquæ cinnamomi..

M. Lew.

3 i

3 iiss

3 v

3x

3 iv

3 xiiss

Dust a little of the powder over the part, once or twice a day, until all tenderness has passed away. If there should be any indication of return, apply the powder at once and continue as before.

ICE IN BURNS.-Dr. J. G. Carpenter ("American Pract. and News") highly recommends the treatment of burns with ice or ice-cold applications. He cites two cases where the treatment was attended by speedy marked success. These applications should be renewed frequently.

VOLKMANN'S ARTHRECTOMY.-Dr. Plum of Copenhagen ("Hospital Tidende") has failed to secure good results from Volkmann's Arthrectomy in knee joint operations. He has found it impossible to obtain fixed anchylosis of the joint in good position, and in two cases a considerable elongation (two or three centime ters) of the extremity operated on, combined with valgus position resulted. He states that total extirpation of the capsule cannot be obtained without opening the lateral ligaments.

DIGITAL DERMOID CYSTS. Dr. Daniel Molliére ("St. Louis Med. and Surg. Jour.") removed a dermoid cyst from the pulp of the thumb of a woman. He had also removed one from the index of another woman.

These cysts are rare, especially at the finger pulps. They seem to take their origin in slight traumatisms such as the prick of a needle, or friction due to occupation or accident. In these cysts, the contents are oily and there is a well-defined capsule. Enucleation is comparatively easy as the cyst envelope is very dense, and easily torn out.

MAMMARY CANCER. The American Practitioner and News" says that there is no surgeon who has removed many cancerous breasts without witnessing a number of cases in which the disease recurred. The "dinner-plate" incision, as the elder Gross called his favorite operation in mammary cancer, though supplemented by the thorough cleansing out of the axillary space, so much insisted upon by the younger Gross, was certainly a great advance over the former practice in these cases. But, in spite of all, it often happens that cancerous material is often left at the site of the operation. To leave a single enlarged lymphatic, or the least bit of cancerous tissue, is to insure the return of the disease. Much as has been done in the surgery of the breast, much remains.

worse, that is, from the second to the third stage, suppuration takes place, and as soon as the capsule is perforated the pain ceases. He has in several cases opened the capsule by a subcutaneous incision during the second stage, with the most gratifying results. By this means the fluid runs into the surrounding tissue, to be absorbed by nature. The pain ceases immediately; the patient is then put in as comfortable a position as possible; the limb is easily The best straightened by manipulation.

method is to put upon the patient a pair of wire breeches. No forced extension is employed. Aspiration as a curative method has failed in his hands. Extension and counter-extension employed upon the fanciful theory that thereby the head of the femur is separated from the acetabulum, is useless. In a healthy joint it cannot be done. The two surfaces are in such close relation-move upon one another so accurately-that there is no room; the vacuum is so small, indeed, and the joint hermetically sealed, therefore it cannot be pulled asunder. Separation of these two surfaces can only take place when disease has destroyed the ligaments and the capsule is opened.

CLUB HAND.--Dr. R. Jones ("Prov. Med. Jour.") says the sooner treatment is commenced the easier becomes the surgeon's task, and he has treated infants only seven days old. The hands should be held by the surgeon, and gently stretched every morning for some days, the severity of the stretching to be gradually intensified until extension can be made by the hand without any great force. He next placed in each of the infant's hands a small wooden bar, allowing the fingers to curl over it- grasp it in fact. Bandage is then used to hold the bar in position, and should be readjusted every one or two days, according to the severity of the grip.

In a fortnight or three weeks, providing good progress is being made, having removed the bars from the hand, he places the forearm in a splint so constructed as to gradually straighten the hand and wrist. This is best attained by employing a zinc or sheet iron splint which the surgeon can from time to time bend. Flexor massage may now be employed either by means of thumb pressure along the separate muscles, by friction, or by flagellation. The hands should next be placed in full extension, and the splints modified, so as to admit of maintaining them in the extended position. This is practically the last phase of treatment, and the hands should be maintained in this position until all tendency to contraction has ceased. This may take a great many weeks, but in his experience always occurs. By this method the lengthened