These cases were of such a nature that under the ordinary course of treatment, none of them could reasonably have hoped for recovery; but being treated on the principle exhibited in the above report, they were relieved and cured perfectly without any "sequelæ," or an ache, or a pain to remind them of the perils through which they had passed. And now, in conclusion, I can say I am not ashamed of my work, having cured all my patients, and am ready at any time to compare notes on this subject with any member of the profession, to whatever school he may belong.

ALBERT B. WHITNEY, M.D.

TREATMENT OF CHRONIC ENDOMETRITIS.

In order to render apparent why good results of an unusually valuable character necessarily attend the use of the treatment here advocated, a sketch of the anatomical structure of the mucous membrane lining the body of the uterus will be necessary. Except at the orifices of the Fallopian tubes, and at the os internum, the mucous lining of the uterus is very much the thickest membrane of its class in the human body, constituting about one fourth the whole thickness of the uterine walls. It is composed mainly of tubular glands, which, opening on its free surface, extend through its whole thickness, ending in a cul-de-sac at the underlying uterine muscular tissue, to which the mucous membrane is firmly attached. It is therefore essentially a glandular structure, and is moreover very vascular, becoming specially so at the approach of, during, and for a few days after the menstrual periods. It is obvious that when such a membrane becomes inflamed, its density, volume, and vascularity present obstacles to its cure of a very grave character. Now inflammation of the uterus and its results are the difficulties the gynecologist is most frequently required to deal with. When these are confined to the cervix the difficulty is removed with comparative ease and certainty; but when the mucous membrane lining the body is inflamed, the prospect of cure, to say the least, is much less hopeful. The recorded results of the treatment of intra-uterine inflammation by the corrosive chemicals now commonly employed, even in the hands of the ablest specialists, is candidly admitted by many of them to be practically a failure. We feel justified in going farther and

stating that such treatment is usually productive of grave injury to the patient, and the time is ripe for an advance in this department of uterine therapeutics.

When a patient suffering from the disease under consideration is treated by the application of corrosive chemicals to the membrane lining the uterine body, her sufferings are always immediately and greatly aggravated. The modus operandi of such an application seems to be as follows: The power of the caustic, whatever it may be, is expended on the surface of the membrane in question only. The deeper parts of the inflamed tissues are never reached by the curative influence of the remedy, if it has any virtue. On the contrary, I believe that the effect is indirectly but powerfully unfavorable. The discharge that oozes from the surface of the diseased tissue is nature's way to keep the inflammatory process in check, but when the mouths of the glandular follicles are sealed up by the caustics usually employed, the discharge is denied exit until the slough separates. During this time it necessarily accumulates in the follicles, distending them and causing painful tumefaction of the uterine mucous membrane, of which every patient is so conscious directly after having been submitted to such treatment. As soon as the slough separates, the mouths of the follicles become free, the imprisoned discharge escapes from the deeper parts of the diseased membrane, the latter recovers measurably from the injury inflicted by the treatment, and the patient's sufferings are mitigated until the next application.

We think it may be accepted as a self-evident truth that no remedies can be curative in the disease under consideration which expend their curative power on the surface of the morbid membrane, while the deeper diseased tissues are indirectly injured. Curative results can be attained with greater certainty by the action of a remedy that favorably influences both the surface of the inflamed membrane, and the deeper parts at the same time, by coming into intimate contact with the whole interior of the inflamed uterine follicles. The extract of hemlock fulfils these necessary conditions admirably. When placed in the interior of a diseased uterus it saturates the inflamed membrane by filling every follicle; thus its healing and astringent influence is exerted on every part. It is not only an astringent of unusual power, but in addition possesses a special tonic influence on the tissue whose treatment we are discussing. We believe it to be specially adapted to the treatment of chronic endo

metritis, in which caustic applications have so frequently proved injurious. We strongly commend it to the confidence of gynecologists, whose experience corroborates the views here advanced concerning the action of caustics. Its application is nearly or quite painless, an advantage always highly appreciated by the patient.

It may be applied in full strength to the uterine cavity by means of a probe, the end of which has been wound with absorbent cotton; or a few drops may be safely deposited there with a Molesworth's intra-uterine syringe; or the extract may be dried until it attains the consistence of a soft pill-mass; this done a bit of the remedy as largé as a pea may be passed within the os internum on the end of a uterine probe: once in the cavity of the womb it soon dissolves and exerts its curative influence on every part of the diseased membrane. Convincing proof of the efficacy of the treatment here advocated is afforded both to the physician and his patient by the improvement promptly experienced by the latter. The best results are secured by keeping the uterine mucous membrane under the influence of the remedy almost continually during a large part of the intermenstrual period. The application should therefore be repeated every second or third day.

In case of inflammatory disease of the mucous membrane lining the cervix, and in glandular degeneration of the membrane covering the vaginal portion of the cervix itself, the use of the extract of hemlock, with such local and general measures as shall readily suggest themselves to every practical gynecologist, yields much better results than can be obtained by any other remedy with which we are acquainted.

DAVID WARK, M.D.

OXYGEN IN THE TREATMENT OF PHTHISIS.

WHEN the eminent chemist, Dr. Priestley, discovered the composition of the atmosphere about 1774, and demonstrated that oxygen was the vital principle of the air, several physicians conceived the idea that it would prove beneficial in the treatment of pulmonary complaints, especially of phthisis. It was used for a time with varying results, but was soon cast aside as worthless. After the lapse of more than half a century, it was again brought forward by Dr. Birch, of England, who published a treatise on the subject in 1857. Since

then it has been used with good success by many physicians in Europe: but it is only within the past ten years that it has come into use here to any extent.

About sixteen years ago I was acquainted with one Dr. Hughes, of London, who was a man of peculiar genius. His heretical views caused him to be censured many times by the College of Physicians, of which he was a member. It was from him I first learned the uses of oxygen as a therapeutic agent. I certainly saw very bad cases of phthisis, asthma, chronic bronchitis, etc., cured by it under Hughes' advice, after being given up as incurable by many other medical men of reputation.

After many years' study of the subject, I am convinced that phthisis is not hereditary; and that its true pathology is neither understood nor taught in any college now existing, so far as I have been able to ascertain. Dr. T. R. Allinson, L.R.C.P., England, proved many years ago that phthisis arises from two causes: 1st, impure air, and 2d, the use of flesh meat, which conveyed the seed of the disease (the bacilli tuberculosis) into the system. It was demonstrated by Dr. Parkes, of London University, about three years ago, that the bacilli tuberculosis in animals and in man are identical, and also that the bacilli are to be found in all parts of the body when present in the lungs. Dr. Behrend, in an article in the Nineteenth Century Magazine for September, 1889, entitled "Diseases caught from Butchers' Meat," corroborates the views of Allinson above quoted, and it may be added that Dr. B. speaks from an experience extending over forty years. The bacilli cannot be detected. in meat unless it is examined microscopically; hence it would seem that the only certain way to avoid phthisis is to avoid the use of flesh as a food, and also to use only milk from a perfectly sound and healthy cow when we use it at all.

As country air is always more rich in oxygen and ozone than city air, consumptive patients should always be sent to the country or the seashore if possible. They should keep in the open air all the time, and also inhale fifteen or twenty gallons of pure oxygen each day. No drugs or medicines of any shape or kind should be given, and alcohol should be interdicted. The injection of carbonic acid gas into the rectum, which was introduced two years ago by Dr. Bergeon and others as a mode of curing phthisis, has proved to be worthless, and even dangerous. The only really successful mode of treating phthisis, asthma, catarrh, and in fact almost all other chronic diseases of the

lungs and air passages is as follows: The patient should have all the fresh air possible, and use the oxygen as already stated; his diet should be fruits, vegetables, brown bread, rice, and pure milk and cream from absolutely healthy cows. He should practice deep breathing four times or so daily for five minutes at a time. If the bowels are not free, inject warm water and glycerine. Bathe once a day in warm water, and be rubbed down well with a Turkish towel afterward. Corsets must not be worn. A Turkish bath three times a week or so is good.

The following case treated by me in 1884 illustrates what I have been saying: Miss M., aged twenty-four, came to me in an advanced stage of phthisis. All the usual symptoms were present. Old Dr. B., of Lexington Avenue, had told her a short time before that she could not live more than six months, and another physician had agreed with that opinion. I told her that I thought she would recover her health, though I had really very little hope myself. I put her on the treatment above outlined, and in less than six months she was stronger, fatter, and healthier than ever in her life before. Soon after she married, and her aunt told me the other day when I met her that she is now the mother of three fine children, and in the best of health, and further that she has not tasted flesh meat. since I told her to give it up. I have had just as good results with many other patients, but the above was I think the most hopeless I ever saw, and, as I said, I really did not expect she would ever regain her health. R. V. O'NEILL, M.D.

POSTERIOR ANGULAR CURVATURE OF THE SPINE.

THE diseased condition of the vertebræ which gives rise to posterior angular curvature of the spine was first minutely described by Percival Pott, in 1779, and has since been generally spoken of as "Pott's disease." The characteristic deformity and the impaired locomotion had been described by the older writers, but they had no idea of the pathological condition of the parts.

The disease begins with an ostitis of the spongy portion of the vertebræ, and the inflammation may extend to the intervertebral cartilages and surrounding tissues. Extensive suppuration and formation of abscess may speedily follow, or a caries of the bodies of the