ON SEASICKNESS. James Reginald Stocker, M.B., M. R. C. P., medical officer in the service of the Cunard line of steamships, contributes to the February number of the New York Medical Journal and Obstetrical Review an article in which, after deprecating the tendency to resort to special drugs in a routine manner in the treatment of seasickness, he suggests the following theory of the mode in which the affection is produced: The pneumogastric nerve sympathizes with the senses and the intellect, and plays an active part in that expression of disgust which results in vomiting. Stimulation of the nerve, in moderation, favors digestion and the various other processes of organic life; in excess it irritates them. It directly occasions nausea, dyspepsia, flatulence, vomiting, etc.; and, indirectly, all the other sad effects of seasickness. The nervous centres, excited by the sensory impressions, become at last so irritable that the introduction of anything into the stomach is resented, and vomiting occurs; until sooner or later the nervous system is dominated by that potent influence for good or evil, the force of habit, and the body finally becomes accustomed to the new sensation. He thinks that the fifth sense, commonly called the 'sense of touch,' or 'common sensation,' is a compound sense. By its means we are able to recognize not only touch and its varieties, but also distance, form, size, weight, consistence, relation, and time, and sometimes even color and sound. The study of seasickness teaches us that there is in us a sense which, without some such experience, we might perhaps be slow to recognize the sense of passive motion. It may not indeed be so exalted a sense as others, nor so important, but it is certainly one which in seasickness deserves consideration. And after all it has its pleasant as well as its painful side when used in moderation; it is the placid sensation that often lulls the child to sleep; it is that of the rocking-horse, the rocking-chair, horse exercise, vehicular motion of all kinds, passive movement of the body in all its forms and phases, only unpleasant, only disagreeable, when used inopportunely or in excess. Conditions which some other observers refer to the falling weight of the viscera, the author is inclined to attribute to a cause a little more remote, but produced partly by that agency. He believes that the feeling of nausea, etc., which ensues upon the falling of the vessel is the same as that due to the backward movement of the swing, or of any vehicle, the downward movement of an elevator, vertical or oblique, as well as in the dance, etc.; and is brought about by the formation of a partial vacuum of the lung. To this cause he also attributes the condition known as mal des montagnes. We have in seasickness conditions almost precisely similar to those of the latter affection, with regard to the effect as well as to the cause: a partial vacuum-produced, not indeed by the rarefaction of the atmosphere itself, but by the subsidence of the abdominal viscera when the vessel falls, and therefore felt more in the upright than in the horizontal positionand the continued movement of the body. The first, i. e., the want of air, is the cause more particularly of that feeling of 'goneness' we so often hear complained of. The author has been in the habit of recommending patients to take a deep breath whenever they felt that sinking at the pit of the stomach, having found it by experience to be an effectual, though not infallible, means of allaying the sensation, and to this he would refer the good effect of singing or of any rhythmic movements that may tend to relieve the mind or to regulate the breathing, as well as the advantage sometimes derived from weight or pressure applied to the stomach by elastic and other belts or bandages. The second, i. e., the movement, is the cause more especially of the irritable condition of the nervous system. The secret of the one is its direct effect upon the pulmonic branches of the pneumogastric nerve, probably the result of a partial paralysis. We know that division of the pneumogastric causes vomiting; the nerve is said to exert an inhibitory effect upon the heart; it has the same effect upon the stomach. It may, however, be due to stimulation of the pneumogastric, for the diminished resistance of the air, according to Liebig, leads to more active elastic contraction of the lung. The secret of the other is its indirect effect upon the same nerve, through the media of the nerves of feeling or common sensation, sometimes indeed through the agency of other senses, as, e. g., by the sight of undulating movements, and by other unpleasant sensations. In each case, practically, the cause is of an eccentric or peripheral character. Similar views, the author remarks, were expressed some fifty years ago, by Herbert Mayo. "The use of the bromides is increasing daily, and he cannot but condemn the practice of using them so indiscriminately and in such large quantities as has lately been recommended. But while there is no specific remedy or panacea for the disorder, many of the conditions may be relieved by medicine. Seasickness, after all, is but a form of passive indigestion, the result of a functional neurosis in which the pneumogastric nerve is either excited or depressed. Like many other functional disorders, if anything is to be done at all for it in the way of medicine, it requires to be treated. One is sometimes surprised at the complete failure in some cases of a remedy which in others has proved of great service; and, conversely, one is sometimes charmed with the effect of a remedy on some which has failed completely with others. With regard, for instance, to the use of alkalies, stomachic sedatives, one seems sometimes to hit upon by chance, to distinguish intuitively, or rather, perhaps, to learn by experience, what particular drug to use in each individual case. The same may be said with regard to aperients, etc. Thus are to be explained the differences and agreements in the opinions of writers. One cure, indeed, there is, viz. : custom or habit. In the course of time it almost invariably asserts itself, and "use becomes a second nature." The sooner one can accustom or habituate one's self to the altered condition of things, the sooner will one become a good sailor. The best means of doing so is to forget it, to banish it from one's memory by the substitution of gymnastic and other exercises, and by learning the art of balancing one's self. The more one is able to forget one's self, the more one's attention can be distracted from one's own condition and diverted to other things and other people, the less will one feel the disagreeable sensations. What people want on board ship is resolution, and, when the will is not sufficient and moral means have failed, the most effectual, though not by any means the most practicable, is to have recourse to force." Dr. Milan Soule, Surgeon on the S. S. City of Sidney, has written an account of his experience with the Bromide treatment for seasickness, as laid down by Dr. G. M. Beard. He says: "I began to use the Bromides with a good deal of doubt and hesitation. Greatly to my surprise and gratification, however, I found that I was able to prevent or greatly to alleviate the disease, and have not one single failure to record. The following is the combination I most frequently employed, viz.: B-Sodii Bromidi 3 iv. 3 ij. Ammonii Bromidi Aquæ Menth. Pip. 3 iij. "M. S.-A teaspoonful before meals and at bedtime; begin treatment three days before going on board. "When preparatory treatment had been neglected and the disease fully established, I put a teaspoonful of the above in a half-tumbler of water, add a drop of ext. Ipecac. fluid, and give a teaspoonful every five minutes; it generally relieves the patient in less than an hour. as it looks more to the individualization of such cases, than any we have before seen on the subject from such a source. The writer many years since accidently hit upon the respiratory plan of relief as suggested in this article, with the modification that inspiration was practised on the downward motion of the vessel and expiration on the upward, graduating the respiratory move. ments to meet those of the vessel, simultaneously. The effect of this procedure is two-fold viz.: 1st, to prevent the tendency to a vacuumin the lungs; and 2d, the production of partial anaesthesia by the process of rapid breathing. We believe that the latter will become an important means in the treatment of this, the béte noir of travel by water.-EDS.] CLINIQUE. EFFECTS OF DUBOISIN AND ESERIN. BY J. L. MOFFAT, M.D., O. ET. A. CH., BROOKLYN, N. Y. J. J. McD., æt. 49, with a rheumatic history, has just recovered from an attack of iritis plastica, which left extensive posterior synechiæ in the right eye. In order to break them up, I instilled (April 6) two drops of a one per cent. solution of duboisin sulfate. Twenty minutes later his mouth and throat felt dry, as though he would be thirsty. staggering; sensitiveness of the spine to the jar of descending steps; deathly paleness of the face; paralysis of the tongue (?); pressive pain in both lumbar regions; coldness (subjective); drowsiness. Eserin caused: Irritation of the mucous membrane; eyelids felt drawn; squeezing and fluttering in the eye ball; myosis; mouth dry; vertigo; twitching of the orbicularis muscles. HAHNEMANN HOSPITAL, NEW YORK. EXTRACTS FROM CASE BOOK. BY WM. BRYAN, M.D., RESIDENT SURGEON. URINARY CALCULUS AND RENAL ABSCESS. No. 1.-A. N., æt. 5, Italian. No family history. Three years ago mother noticed that the child suffered when urinating, making frequent ineffectual attempts to evacuate bladder. For two years has not passed 3 ii. at any one time. Will roll on floor, scream, much der satisfactorily. Has noticed blood in urine, nothing bearing down, pulling penis, but never emptying bladmore. When admitted, had not passed urine in 24 hours. few drops of blood and pus. Catheter introduced, no urine drawn, only a A tumor size of cocoa-nut can be seen and felt in hypogastric region, apparently a distended bladder. Twelve hours after admission, needle of aspirator introduced above pubes, but no urine withdrawn. There was reason to suspect stone: as patient was then in a collapsed condition, and immediate relief necessary, ether was administered and a supra pubic incision made by Dr. Helmuth; finger introduced and bladder explored. A calculus was detected imbedded at neck of bladder and removed with difficulty. Wound left open, patient put to bed, warmth applied to extremities and stimulants given. Operation did not take five minutes in all. He died one hour after. Post-mortem: Bladder empty, walls thickened, contracted, capacity about i., no urine. A large abscess was found extending from and involving lower On proceeding, he found that he staggered as if drunk, part of right kidney, bounded internally by spinal coland had to concentrate his energy and look directly umn, externally by ascending colon, holding about ahead, for upon looking to one side there was a disposi-vi. pus. Kidney disorganized, small collections of tion to fall towards the opposite side. Going down stairs, or curbstones, was difficult; every step jolting his back as if he had (to use his own expression)" stepped down from the top of a house." April 8, 2.23 P. M.-Instilled two drops eserin, one per cent. solution, and as much more 9 minutes later. In about 15 minutes a sensation of squeezing together in the ball, and a feeling as though the lids were drawn. In about 15 minutes from the first instillation, the pupil, from being irregular in shape, averaging about 3.5 mm. in diameter, had contracted to a circle 2 mm. across. At 3.07 P. M., and at 3.53, two drops of dubois. were instilled. About 10 or 15 minutes later, he was going home from the Dispensary, and upon turning to the right suddenly fell to the left, overcome by intense confusion, vertigo and weakness. He was deathly pale; felt exhausted, as from want of sleep, and experienced great confusion, with a sense of lightness throughout the body and head. The tongue felt "flat," and he could not articulate distinctly (paralysis?). The next day he awoke with a very severe pressive pain in the lumbar region on each side, which gradually disappeared as he moved about. April 10. He felt cold and chilly; wanted to wear extra clothing, which made him feel comfortable. In the afternoon Dr. Searle instilled more dubois., and a few moments later he felt very drowsy; the symptoms of confusion, lightness, drowsiness, thirst, and weakness were again experienced, but relieved by a cup of strong coffee. April 11.—Tension slightly less than before; still not minus. 2.30 P. M.-Instilled one drop of exerin. In five min utes, mouth dry, slight vertigo. Six minutes later, a drawing, fluttering sensation in the ball, and spasmodic twitching of the m. orbicularis palp. I should add that the dubois. also caused a soreness in the right side of the nose; as if the drug irritated the mucous membrane as the tears escaped through the lachrymal duct. SUMMARY, Duboisin caused: Mydriasis; dryness of the mouth and throat; thirst; vertigo, falling to the side opposite to that whither he turned his eyes; lightness of the body and head; intense confusion; weakness; exhaustion; pus seen all through substance of right and left kidney. Calculus was size of hickory nut, mulberry form, occupied a sac formed by neck of bladder and upper lobe of prostate gland. URETHRAL STRICTURE WITH FISTULA. An Contracted gonorrhoea 18 years ago. INTERSTITIAL PNEUMONIA. No. 3.-Wm, H., æt. 23, unmarried, cigar packer by trade. No hereditary taint. Had always enjoyed good health until présent illness. Three months before admission was obliged to discontinue work on account of failing strength. Complained of languor, chilly sensa tions, and restless. Had not been exposed to inclement region, discharged through vagina. Had another three weather, and knew of no exciting cause. One week after leaving work began to cough, had sharp pain in right chest, expectorated stringy mucus, slight fever, no chill. Was treated for pleurisy, and an unfavorable prognosis had been given by his attendant. He entered the hospital in a despondent state of mind. On examination, body found to be emaciated, tall, thin, spare figure, sallow complexion, anæmic. Night sweats. Right chest wall retracted, no bulging of intercostal spaces, not much expansive movement. Vocal fremitus increased, dull sound on percussion. Respiratory sound very feeble, and entirely absent over some portions of lower lobe, a few mucus râles heard. Över left lung respiratory sound intensified. Heart drawn over to right side. Expectoration slight light colored, no blood. Pulse ranged from 90 to 110, temperature from 99 in morning to 101 in evening. Dr. Dowling diagnosticated interstitial pneumonia and gave a favorable prognosis. He was advised to give up his trade, as that, very probably, had had much to do with his illness, and seek employment where he would have more out-door exercise. A liberal diet was ordered and internally aconite, bryonia phos. and sulph. were given as indicated. He rapidly improved under this course of treatment, and when discharged had gained flesh ALBANY CITY HOMEOPATHIC HOSPITAL AND and strength, ate and slept well, no sweats, cough, or fever; some respiratory sounds heard in right lung. TRAUMATIC EPILEPSY. No. 4.-J. C., æt. 18. No family history of importance. When nine years old he fell and sustained an injury to scalp, at the time considered slight, readily healed, and no further attention paid to it. Months after the cicatrix became tender, he complained of headache, inability to concentrate his thoughts or perform any mental labor. Six years after injury he noticed slight muscular twitching of flexor muscles in right arm, at irregular intervals, for about one year, then he had his first epileptic convulsion. The attacks at first were at long intervals and not very severe, but lately are increasing in frequency and severity. Various methods of treatment had been tried without avail. He was admitted to the hospital, and Dr. Minor trephined over old cicatrix, near anterior superior angle of right parietal bone. He made a rapid recovery from the operation, left the hospital, and has reported several times since. Does not have convulsions now and is considered cured. PROCEDENTIA UTERI WITH COMPLICATIONS. No. 5.-Mrs. E. T., æt. 48. Mother of four children, the last born four years before admission. She had always been a healthy woman, a hard worker, having spent much of her time on a farm. Nothing unusual with any of her labors. Was in the habit of getting up and attending to her duties within a couple of days of delivery. One year ago uterus became completely prolapsed. so that it was entirely without the vulva. She had put on a T bandage for support, and gone about as usual. When admitted, the uterus was twice its ordinary size, and hung down between thighs without giving rise to any annoyance. Probe passed in four inches. Mucous membrane covering uterus, and the prolapsed vaginal portion had become dry and thick, like ordinary integument. Cervix larcerated in three directions, and required much local treatment to get it in a fit condition for operation. Dr. McDonald operated on it, after which the body of the uterus diminished very much in size, so that it was possible to retain it within the pelvis. Afterward an operation was done on perinæum, so that it would afford the necessary support, and a pessary was then fitted which sustained the uterus in position. OVARIOTOMY WITH RECOVERY. No. 6.-Mrs. B. C., æt. 26. Carcinoma hereditary. Always enjoyed excellent health until 19 years old. Then had an abscess in neighborhood of right inguinal DISPENSARY. BY J. J. PECKHAM, M.D., RESIDENT PHYSICIAN. In the hospital one hundred and four cases were treated during the year 1881, and in the dispensary 1,402 prescriptions, with 575 minor surgical cases. REPORT OF SURGICAL CASES. The surgical department of the hospital is under the care of Drs. Swinburne and Balch. The following are among the more important. Fracture of the Left Femur.-The patient, a woman, 58 years of age; injury caused by a fall from a step ladder; the left femur was broken at its lower third. Treatment by extension, ten pounds being applied; hot water dressings were continually applied at the point of injury. Patient discharged cured at the end of three months; no shortening of the limb. Fracture of the Right Femur, the Left Fibula, and the Horizontal Ramus of the Left Pubis. -The patient, a male, 23 years of age, a brakeman on a railroad, injured by being crushed between cars and a pile of pig iron. Patient died from peritonitis on the third day after the injury. Amputation of the Left Leg.-The patient, a male, 19 years of age, brakeman on a railroad, injured by a car soft parts. The leg was amputated at the lower third, wheel passing over the ankle, crushing the bones and by Dr. Balch. Hot water dressings were applied to the stump, which was also cleansed twice daily with a solution of nitric acid, ten drops to the ounce of water. The patient left the hospital cured, at the expiration of nine weeks. Vesico-vaginal Fistula. The patient was 45 years of age, married. The fistula followed her last confinement, which occurred eighteen months previously; it was located at the base of the bladder, and was about an inch in length, through which opening a portion of the organ protruded. The operation was performed by Drs. Swinburne and Balch. Nine sutures were required to bring consisted of injections, twice daily, into the bladder and the edges of the fistula together. The after treatment vagina, of hot water acidulated with nitric acid in the proportion of ten drops to the ounce. Nourishing food end of four weeks, the operation having been so far sucwas freely given. The patient left the hospital at the cessful as to prevent the prolapsus of the bladder. second operation will be required in order to effect a complete cure. A Amputation of the Left Leg.-The patient a male, 58 years of age, a laborer on the railroad, was injured by a car wheel passing over the ankle crushing the bones and soft parts. The operation was performed by Dr. Swinburne. The great loss of blood following the injury, the age of the patient, and a contused condition of the leg as far up as the knee, caused extensive sloughing of the upper flap. During this stage the febrile condition was marked, the evening temperature ranging from 102.5 to 104.5. Hygienic and dietetic measure were thoroughly applied. Quinine was administered during the fever; hot water was applied to the stump; the wound was washed once daily with a strong solution of nitric acid. After the sloughing ceased the patient rapidly recovered, and was discharged cured. Fracture of the Occipital Bone, the Right Scapula, and the Seventh and Eighth Ribs on the Left Side.-The patient, a male, 32 years of age, a painter by occupation, was injured by falling a distance of twenty-five feet. The fractured ribs and scapula were secured by means of strips of adhesive plaster placed around the body and over the shoulder and back on the injured side. The patient was kept as quiet as possible. He was discharged cured at the expiration of eight weeks. Compound Comminuted Fracture of the Right Tibin and Fibula.-The patient, a male, was injured by the wheel of a loaded coal cart passing over the right leg, fracturing the bones at the middle third. The fracture was treated by simple extension, and the seat of injury was dressed with hot water. Several pieces of bone came away. The fractured fibula rapidly united; the sloughing of the soft parts was extensive, and the union of the fractured ends of the tibia, slow. After twelve weeks the extension was removed, and the leg encased in a plaster-of-Paris bandage, the patient then being able to walk about the ward on crutches. The patient is still under treatment, and rapidly improving. Fracture of the Right Tibia, with Dislocation of the Ankle Joints of Both Feet.-The patient, a male, 19 years of age, was injured by falling a distance of forty feet, striking upon his feet and fracturing the right tibia at the middle third, also the astragalus of both feet, and dislocation of the tibia and fibula of each leg at their lower ends. Amputation of both feet seemed inevitable; the treatment, however, was directed toward the saving of both limbs. Hot water dressings were applied from the knee down, and the patient kept quiet by means of anodynes. The dislocations were reduced as far as possible, and methods adopted with a view of gradually bringing the feet and ankles into their natural positions. Several abscesses formed in the ankles, which were opened. In twelve weeks after the injury was received, the natural lines and positions of the legs and feet were nearly or quite established, and the natural movements of the joints nearly restored. The patient is still under treatment at the hospital. Urinary Calculus.-The patient, a male, 24 years of age, had been suffering two years with stone in the bladder. The operation for its removal was performed by Dr. Swinburne. The stone weighed an ounce. The wound healed in ten days, the urine then passing naturally through the urethra. In two weeks after the operation the patient was able to walk about the ward; and in six weeks had entirely recovered. The local treatment consisted in applying hot water to the wound, and washing out the bladder twice daily with hot water into which was put a weak solution of nitric acid. Fracture of the Right Radius. The patient, a male, 40 years of age, was injured by a kick of a mule, frac turing the right radius at the lower third. Extension and counter-extension were applied by means of a straight posterior splint, secured by adhesive plaster to the arm and hand, both above and below the seat of the fracture. In three weeks the splints were removed, and the patient discharged. Compound Fracture of the Right Femur and Lacerated Wounds of Both Legs. The patient, a man, 43 years of age, a brakeman on the railroad, was injured by the wheels of a freight car passing over both legs. The right femur was fractured at the lower third. A lacerated wound extended from the point of fracture to the knee, also a lacerated wound of the left leg, running obliquely over the knee involving the joint. When admitted he was suffering from shock. Stimulants were administered and the injuries dressed with hot water. The patient died from shock in thirty-one hours after receiving the injury. Compound Fracture of the Right Radius with Dislocation of the Ulna.-The patient, a boy, 15 years of age, was injured by falling a distance of 25 feet. The right ulna dislocated at the lower end; he also received severe bruises about the face and right shoulder. The dislocation was reduced, and the fracture dressed; extension and counter-extension were applied by means of a straight posterior splint secured to the arm and hand, both above and below the seat of fracture. Hot water dressings were applied to the injured arm and shoulder, and to the face. The patient was discharged cured in four weeks. Fracture of the Left Radius -The patient, a woman 58 years of age, was injured by falling upon the sidewalk, the left radius was fractured at the lower third. Extension and counter-extension were applied by means of a straight posterior splint, secured by adhesive plaster to the arm and hand both above and below the seat of fracture. In five weeks the splint was removed and the patient discharged. Cancer. The patient, 49 years of age, married, suffering from a cancer involving the right breast. The operation for its removal was performed by Dr. Swinburne. The breast was removed en masse, also several small cancerous growths from the right axilla. The wound was partially closed by pins. Treatment:-Aconite 1st and arnica 1st every hour in alternation. Hot water dressings were applied to the wound. The patient made a rapid recovery, and left the hospital cured, in four weeks. AN EXCLUSIVE MILK DIET WILL occasionally be accompanied by large accumulations in the rectum of masses of pultaceous and extremely tenacious fecal matter, removable only by mechanical means. Dr. D. W. Niles, of Worcester, Mass., has recorded some observations of this character, and also some experiments on healthy individuals. In all the cases the physical characteristics of the deposit were the same, of bright yellow color, soft, greasy, exceedingly adhesive, not soluble in water and not removable by cathartics or injections. These observations have shown him that this result will likewise occur when lime water has been given with the milk. Dr. Niles calls attention to the fact that when constipation ensues upon a milk diet, in children or adults, the contents of the rectum should be investigated.-Brooklyn Proceedings. BUTTER-FUNGUS.-Dr. Kützing (Hom. Rundsc.) has lately discovered a new fungous growth in butter. The fungus presented the appearance of threads, with distinct but delicate twisted fibres. The microscopic examination showed that the fungus-like, brown-colored structure was a new formation. The action of this fungus upon the butter is as follows: The mass of butter becomes porous, in consequence of the extension of the thread-like processes of the fungus, and the entrance of air is thereby facilitated. The oxygen of the air is transformed into ozone, and this produces-by combination with the fat of the butter-a decomposition of the entire mass, so that it becomes sour and rancid. (T. M. S.) DR. BOISSARIE (Annales de Gynecol.) reaffirms the danger, which has lately been doubted, of the prolonged use of ergotin by the mouth. Its hypodermic adminis tration he believes less injurious. Three cases of death from gangrene are noted. THE SIXTEEN COMMANDMENTS OF THE PARIS ACADEMY OF MEDICINE. The Academy has condensed into the following propositions (Trans. in New Orleans Med. and Sur. Jour.) the most important hygienic rules for the care and management of infants: I. During the first year the only suitable nourishment for an infant is its own mother's milk, or that of a healthy wet nurse. Suckling should be repeated every two hours-less frequently at night. II. When it is impossible to give breast milk, either from the mother or a suitable nurse, cow's or goat's milk given tepid, reduced at first one-half by the addition of water slightly sweetened, and after a few weeks onefourth only, is the next best substitute. III. In giving milk to an infant always use glass or earthenware vessels, not metallic ones, and always observe the most scrupulous cleanliness in their management, rinsing whenever used. Always avoid the use of teats of cloth or sponge so frequently used to appease hunger or quiet crying. IV. Avoid carefully all those nostrums and compounds so liberally advertised as superior to natural food. V. Never forget that artificial nourishment, whether by nursing bottle or spoon (without the breast) increases to an alarming degree, the chances of producing sickness and death. VI. It is always dangerous to give an infant, especially during the first two months of its life, solid food of any kind-such as bread, cakes, meats, vegetables or fruit. VII. Only after the seventh month, and when the mother's milk is not sufficient to nourish the child, should broths be allowed. After the first year is ended, then it is appropriate to give light broths or paps, made with milk and bread, dried flour, rice, and the farinaceous articles, to prepare for weaning. A child ought not to be weaned until it has cut its first twelve or thirteen teeth, and then only when in perfect health. VIII. A child should be washed and dressed every morning, before being nursed or fed. In bathing a child temper the water to the weather, carefully cleanse the body, and especially the genital organs which require great cleanliness and care; and the head should be carefully freed from all scabs and crusts which may form. Where the belly-band is used it should be kept on for at least one month. IX. An infant's clothing should always be so arranged as to leave the limbs freedom of motion, and not to compress any portion of the body. X. An infant's clothing should be studiously adapted to the weather; avoiding at all times exposure to the injurious effects of sudden changes in temperature without proper covering; but nurseries and sleeping apartments should invariably be well ventilated. XI. An infant should not be taken into the open air before the fifteenth day after birth, and then only in mild, fair weather. XII. It is objectionable to have an infant sleep in the same bed either with its mother or nurse. XIII. No mother should be in too great a hurry to have a child walk; let it crawl and accustom itself to rising on its feet by climbing on articles of furniture, or assisted by the arms of a careful attendant. Great care should be taken in the too early use of baby-wagons, etc. XIV. No trifling ailments in infants, such as colics, frequent vomiting, diarrhoea, coughs, etc., if persistent, should be neglected-a physician's advice should be at once obtained. XV. In cases of suspected pregnancy, either of mother or nurse, the child should be weaned at once. XVI. A child ought to be vaccinated after the fifth month, or earlier should small-pox be prevalent. M. ROBIN states (Le Progrès Méd) that the presence of indican in urine affords a very valuable diagnostic sign of typhoid fever. "ANÆSTHETICS MEDICO-LEGALLY CONSIDERED," is the title of an interesting and instructive paper by Dr. J. G. Johnson, read before the Medico-Legal Society of New York, Dec. 7, 1881. The points made, as summed up by the writer, are: "1. Anæsthetics do stimulate the sexual functions; the anogenital region is the last to give up its sensitiveness Charges made by females under the influence of an anesthetic should be received as the testimony of an insane person is. It cannot be rejected; but the corpus delicti aliunde rule should be insisted on. Dentists or surgeons who do not protect themselves by having a third person present do not merit much sympathy. 2. Death from administration of chloroform after a felonious assault, unless the wounding was an inevitably fatal one, reduces the crime of the prisoner from murder to a felonious assault. "3. The surgeon has no right to use chloroform to detect crime against the will of the criminal. "4. The army surgeon has the right to use chloroform to detect malingerers. "5. The medical expert, notwithstanding he is sent by order of court, has no right to administer an anesthetic against the wish of the plaintiff in a personal damage suit, to detect fraud. "6. Gross violations of the well known rules of administering anæsthetics, life being lost thereby, will subject the violator to a trial on the charge of manslaughter. 7. A surgeon allowing an untrained medical student to administer anæsthetics, and life being thereby lost, will subject the surgeon himself to a suit for damages. What he does through his agent he does himself. "8. The physician who administers an anesthetic should attend to that part of the work and nothing else. He should have carefully examined the heart and lungs beforehand. He should have the patient in the reclining position, with his clothes loose, so as not to interfere with respiration; should have his rat-tooth forceps, nitrate of amyl, and ammonia, and know their uses, and when to use them and artificial respiration. "9. In operations on the ano-genital region and the evulsion of the toe nail, complete sensation in these parts should never be allowed, and no operation on these parts at all should be had under an anesthetic unless by the approval of a full consultation, who have a knowledge of the dangers. "10. Chloroform cannot be administered to a person who is asleep without waking them, by a person who is not an expert. Experts themselves, with the utmost care, fail more often than they succeed in chloroforming adults in their sleep." The paper concludes as follows: "Another question I would have discussed had time permitted, is whether a physician has the right to administer anæsthetics to mitigate death agonies. Take hydrophobia for instance, when death is inevitable; when the paroxysms of pain are frightful; when the danger to the surgeon in the administration in the ordinary way is extreme. Has he any right to alleviate this suffering, when the patient may pass away suddenly from the chloroform? A few years ago a clergyman was convicted of murder in the second degree in England. He was a missionary among the poor in London, and when he found them with cancer and other incurable diseases, and without the means to obtain the necessaries for their comfort, at the sick person's request he would administer a dose of morphia sufficient to carry them off, and he was transported for life as a convict for thus relieving incurable suffering. Would the physician who intentionally administered chloroform enough to a hydrophobic patient to cut short his suffering come under the same rule?" THE gastroscope, in the hands of a skilled manipulator, makes possible a thorough examination, by the eye, of the œsophagus and stomach. |