sumption exists, the galvanic current is a treatment of great promise. The positive pole is placed about half an inch above the clavicle, on the inner edge of the sterno-mastoid, over the painful nerve; the negative, over the nerve just below the inferior maxilla. The current should not exceed five or six milliamperes or last more than five minutes. If both cords are affected, both nerves should be treated, with an interval of ten minutes between the applications. The voltaization, says Dr. Libermann, should be practiced twice a day. In the course of a fortnight the changes in the voice disappear, as also the hemoptysis. The vocal cords recover their tonicity, which is an evidence of the restoration to the normal of the pneumogastrics. In more advanced cases, cod-liver oil with creosote and phosphate of lime are given, and hemoptysis is checked by perchloride of iron spray. The hemoptysis, the cough, and the night sweats are also treated by short douches of hot water, followed by a short, cold shower-bath.-London Lancet. The Etiology of Peritonitis.-Fränkel has recently published in the Centralblatt für Gynäk. his observations in fifteen cases of peritonitis. In all the purulent cases he found spaltpilze or schizomycetes (a class of unicellular organisms allied to the algæ. They multiply by transverse division and also in some cases by formation of spores. This class includes, bacillus microcccus, spirillum, etc. R. S. N.). While many varieties of micro-organisms were found a special form of streptococcus was in all cases but one. After the peritoneum has been infected by the micro-organisms which excite the inflammation, the morbid process proceeds rapidly to its end. The streptococcus found he considers identical with that of erysipelas. The other varieties of bacilli found had the property of destroying certain albuminoid bodies, many of them also producing toxic substances which even after the death of the bacteria were very virulent to the organisms of animals. He found that cultures of these streptococcus which had been subjected to a high temperature were harmless. Pilocarpine in Jaundice.-Witkowski considers pilocarpine almost a specific for jaundice, and if the disease lasts beyond fifteen days after treatment a malignant growth may be suspected. He administers the drug hypodermically once or twice a day, according to the severity of symptoms, using one-sixth grain for each injection. Witkowski has succeeded in over thirty cases, and only failed when malignant disease existed.-Gaz.- Therapeut, June, '90. Tubercular Meningitis in Children. Diagnosis.-Four symptoms when existing together are convincing; viz., persistent vomiting, irregular pulse, irregular breathing, and apathy. The vomiting is apt to be marked when the meninges of the base of the brain are the seat of the tubercular deposit. If the tubercular deposit is not marked in this region, the vomiting is apt to be less pronounced, or absent. Distinction should be made between the cerebral type of vomiting which is projectile and not accompanied by nausea, and that which is merely reflex or of gastric origin. R. S. N. Treatment of Malaria.-In the Philadelphia Hospital, malarial attacks are treated with sulphate of quinine 20 grains a day, with pilocarpine muriate (gr. ) at the onset of the paroxysm. The latter shortens or even arrests the chill and fever, and hastens and promotes sweating. Spirit of chloroform, in doses of a drachm, is also sometimes used to abort a chill. In the Pennsylvania Hospital, a hypodermic injection of morphine is sometimes given at the time for the onset of the chill or even before it is experienced, with the result of preventing its appearance. The enlargement of the spleen is treated with ergot and Fowler's solution, and ointment of the biniodide of mercury externally. At the Medico-Chirurgical Hospital, hydrochlorate of quinine is preferred, and strong coffee used to abort the paroxysm. Inasmuch as the liver is often clogged with pigment, the treatment should commence with a mercurial purge, such as compound cathartic pills, or calomel and jalap. After this has acted, the quinine will be more effective. Asthma. In the Polyclinic Hospital of Philadelphia, Dr. Thos. J. Mays uses hypodermic injections of strychnine and atropine in asthma (1), to alleviate the attack and (2) to prevent its recurrence. He begins with grain of strychnine, and grain atropine daily, gradually increasing them to gr. and respectively. Due attention should be paid to diet and general hygienic treatment. He considers this a valuable addition to asthmatic therapeutics. Appendicitis.-Dr. F. W. Murray presented a young man whose case had been diagnosticated by a dispensary physician as perityphlitic abscess. The patient had come to St. Luke's Hospital, where a similar diagnosis was made. An operation was urged, but declined; on the following day the patient had changed his mind, and his abdomen was opened by an incision three inches in length on the outer side of the right rectus muscle. The abdominal tissues were found matted together and thickened. The abscess wall was opened and a quantity of very fœtid pus was discharged. The inner wall of the abscess, which was intra-peritoneal, was formed by a coil of intestine. A smaller cavity was found, from which a fæcal concretion was extracted. It was also seen that the end of the appendix had sloughed away. A counteropening was made in the loin above the ilium, through which a large drainage-tube was passed into the abscess cavity, which was then packed with gauze. The general peritoneal cavity was washed out and a glass drainage-tube was inserted and secured in the lower angle of the abdominal wound. two sutures were used in closing the wound. very well. In three weeks he was out of bed. fectly well and had gone back to work. The speaker was rather glad he had made the error of making the incision somewhat too far outside the muscle; but for this he might have opened directly into the abscess and thereby enhanced the danger of infection of the peritoneal cavity. Another point of note was the good condition of the patient, considering the state of things, and it went to show that it was impossible to predict exactly what would be found until the dissection was made.-N. Y. Med. Jour., Aug. 23, 1890. Iodoform gauze and The patient had done A New and Rapid Test for Sugar.- At a meeting of the Austrian Surgical Society last week, Professor Nothnagel showed a handy test for sugar, which had been forwarded to him by Dr. Becker, of Cairo. It is simply a visiting card saturated with a solution of potash, over part of which is drawn a covering of the sulphate of copper, and the urine applied. The card is then laid on the globe of a lamp, when the saccharine urine will color the card brown, and this color will be deeper the greater the amount of sugar.-British and Colonial Druggist. Premonitory Symptoms of Phthisis.-M. Réne Serrand has just published a work in which, among other questions relating to tuberculosis, he has made a special study of the first symptoms of phthisis, he says: In patients doomed to pulmonary phthisis there always exist very clear and decided pharyngo-laryngeal signs, which precede for some time the pulmonary symptoms. These signs are three in number: 1. Pharyngeal anæmia. The pharanx is pale, white, disordered, in place of having its normal color. 2. Impaired action of the inferior vocal chords through atony of the constrictors. Local congestion of the arytenoid and interior arytenoid mucous membrane, manifesting itself in swelling and a cherry-red inflammation of the locality. The These three signs may exist simultaneously or alone. presence of even one is a strong indication of approaching pulmonary tuberculosis; whenever a physician finds all three present, this prognosis is certain. Pharyngeal anæmia, impairment of the vocal chords, and congestion of the arytenoid region, symptoms which have nothing in common with laryngeal phthisis, are the heralds of pulmonary consumption. The physician who knows how to read the larynx of his patient can avoid a great many missteps, for, warned of the danger ahead, he can institute a prophylactic treatment, and arrest phthisis in its first stage. -BIRDS are furnished with a natural substitute for spectacles. They have the power of contracting the eye, making it more convex so as to see the specks which float in the atmosphere and catch them for food; and also of flattening the eye to see at a great distance, and observe whether any vulture or other enemy is threatening to destroy them. They have likewise a suitable covering which they can draw over the eye at will to protect them from the injuries incident to a rapid flight, and an air bag which they can contract when they wish to come down and expand when they wish to rise up. Lectures of Prof. Mapes, 1846. -REFERRING to exclusive rights awarded by law to physicians as a class belonging to what is called "the Regular School," Count Zedtwitz says: "Only by the most resolute resistance will legislators be brought to realize into what frightful injustice and inhumanity they have suffered themselves to be betrayed by a domineering trades' union, which, though it lives upon the diseases of mankind, has yet, with comical simplicity, been constituted guardian of the public health; 'the goat,' to use a German proverb, being thus appointed head gardener." Editor's Table. THE DOCTORS' CRUSADE IN PENNSYLVANIA. THE Medical law at present in force in Pennsylvania, which provides for the Registration of Physicians, has not proved to be sufficiently hide-bound and arbitrary to suit the individuals who aim to place medical practice in that State absolutely in the hands of a partisan and political medical oligarchy. Yet there were reasonable grounds to apprehend that this law was in direct contravention of the Constitution, which formerly assured to citizens of one State the rights of citizens in another, inasmuch as it requires the diplomas granted by colleges in sister States to be indorsed by colleges in Pennsylvania before the holders can engage in the legitimate pursuit of their calling as physicians. The Medical Colleges one and all, enforced the statute as a private law for their benefit, thus enabling them to exclude physicians from practice who had graduated in other States. The law has this sinister clause: "The Faculty (of a medical college or university) being satisfied as to the qualifications of the applicant and the genuineness of the diploma." Of course no jurisdiction this side of the bottomless pit can compel men to be “satisfied," who are determined not to be. The term is a slippery one and slippery men use it as a sanction for refusing to obey the obvious intention of a statute. So distrustful, however, have the judicial authorities been of the validity of the measure, that it became almost a dead letter. It did not help the college monopoly as was expected, and the average Old-School practitioners, who hoped to get rid of competition from abler men, were sadly disappointed. Perhaps no more inveterate exclusiveness in medicine exists anywhere than in Pennsylvania. General Jackson is said to receive votes there yet for President; and many other of these medical men seem yet to believe with Parson Jasper that "the sun do move." Like the tailors of Tooley Street, they consider themselves "the whole kingdom." Two years ago they decreed that the Legislature should pass a bill to create a State Board of Medical Examiners. In this board |