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is frozen as hard as ice, but, strange to knife. He is of the opinion that in the say, in a few minutes circulation returns use of liquid air in medicine, that is to without any injury to the tissue, provided say, in pulmonary diseases, in the reducthe part is not in the end of some ex- tion of fever, etc., a large field is open tremity. There is no pain in the applica- which presents many obstacles at the very tion excepting at the very beginning, but start, and possibly holds out much hope in there is a slight burning or tingling. It the future.-Phila. News. also completely anesthetizes the part to which it is applied without freezing it

Asthma. solid. Dr. White has tried liquid air as a The following prescriptions were recomlocal anesthetic in a number of cases with mended by Dr. Pepper for asthma, in the invariable success. It has one important attack: advantage; that is the absence of hem- R orrhages during the operation, enabling Morphine sulphatis the operator to apply the dressing before Strychninä sulphatis any hemorrhage sets in, the dressing then Hyosciuæ hydrobromatis. . gr. 1-160 being sufficient to stop any oozing. Dr. M. Sig. Administer by hypodermie White has found the use of liquid air injection each night. beneficial in the local treatment of ulcers, R etc. He states that an abscess, boil or Ethereal tincture of lobelia . . oz. ii carbuncle in the early stages is aborted Tinct. of asafetida

oz. i absolutely with one thoro treatment. If Tinct. of opium

OZ. SS it is more advanced, several applications Potassium iodid

. dr. ii at intervals of twenty-four hours are nec- Syrup of tolu essary. Liquid air has also been used

M. Sig. From one to two teaspoonfuls with advantage in cases of sciatica, neu- every one or two hours for an adult, acralgia, etc.

cording to the severity of the case. An interesting experiment was tried in a case of ivy poisoning, involving the B entire left forearm and hand. A band Ammonii bromidi

dr. vi around the forearm about three inches Ammonii chloridi

dr. iss wide was slightly frozen by the spray, and Tinct. lobeliæ ..

dr. iii then the usual treatment was applied to Spiritus etheris comp.

Oz, i the entire poisoned area, including the Syrupi acaciæ ad.

oz. iy part which had been treated with the M. Sig. Dessertspoonful in water every liquid air. At the next dressing the part hour or two during paroxysms. which had been treated with the air was very distinct, and this portion was greatly The following prescriptions have been improved, the inflammatory process bav- used with varying success: ing subsided. A number of other diseases R have also been treated with liquid air with Extract euphorbiæ piluliferæ . m. iii markt success. Where no loss of tissue is Nitroglycerin .. desirable, liquid air should be applied by Sodii iodidi . the spray and not by the swab. Dr. White Potassii bromidi takes issue with Mr. Hampson. Dr. White Tinct. lobeliæ .

m. ji is undoubtedly correct in advising the M. Ft. pil vel capsul, No. 1. Sig. From greatest possible care in using the new one to four three times a day. substance which science has placed at the For inhalation : disposal of the surgeon. Even such cool. R ing agents as the ether-spray should be Potassii nitratis used with great caution, and liquid air Pulv. anisi fruct. should be applied only by those who have Pulv. stramonii fol. had some experience in its use.

M. Sig. Use a thimbleful, place on In conclusion, Dr. White considers that plate, light with match, then inhale fumes. we have reason to hope that we have in —Jour. Amer. Med. Assc. liquid air a therapeutic agent which will remove many otherwise obstinate super- A mixture of equal parts of lactic acid ficial lesions of the body and cure some and glycerin, applied to the face twice a lesions which have hitherto resisted all day as a wa-lı, is of value in removing treatment at our disposal, including the freckles.-Med. Brief.

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is allowed to flow for from fifteen to thirty By William V. Morgan, M.D., Department Editor of the Med. minutes, according to the size of the and Surg. Monitor, of Indianapolis.

growth and the effect produced. On In true ankylosis, when an attempt is account of the coagulating effect of the made to flex the limb, pain will only be positive pole, the needle will be difficult to experienced at the points where pressure is withdraw unless the current be reversed made, but in false ankylosis the pain will for a short time. A repetition of this be in the joint.

treatment once or twice a week, according

to indication, can be depended upon to Ammoniacal urine gives olfactory evi- give excellent results. The bunglesome dence of infection cystitis. Ammoniacal mistakes so frequently coming under the decomposition in the bladder can only observation of the writer justify the sometake place as the result of the presence of what elementary injunction, “Do not use pyogenic micro-organisms and should a Faradic battery to secure electrolytic always be the signal for cystic lavage and

effects." The enlarged nevi (angiomata) the administration of diluents.

of the lips can be attackt by the sharp point of a Paquelin cautery heated to a

cherry color. Such tumors are better A differential diagnosis between a femoral and an inguinal hernia may usually that no visible scars may result. This

treated from the mucous surface, in order be made by observing the relation that the

method is much superior to excision, and protrusion bears to the tendon of the ad

on account of its simplicity, effectiveness ductor longus muscle. By abducting the leg this tendon stands out more promi- and freedom from mutilation, merits entire nently than any other tendon inserted into the pubes. Hernias lying to the inner (median) side of the tendon are of

If a physician is cool-headed and has a the inguinal variety, and those to the reasonable degree of ingenuity, he will outer side are femoral.

seldom be caught in an emergency from

which he cannot extricate himself. SupThe surgical principles for the treatment tention of urine and you are several miles

pose you have a patient suffering from reof a nevus (mother's mark) should be

from a catheter. If nothing better is at based upon the truth so plainly and tersely hand, take some wire from a broom, enunciated by J. Bland Sutton: “A nevus

sterilize it, bend it double and pass the should be cut out, not into." The lesson blunt end into the bladder. The groove taught by the hemorrhage which results

on each side of the doubled wire will allow from disobeying this rule would surely not

the urine to slowly dribble away, and you require repetition. It is never safe to in

can have time to meditate upon the esthetic form a patient that a nevus will not grow

side of life. The writer once saw a patient larger. On the exposed surface of the

of Dr. Wm. B. Fletcher who was suddenly body (and especially upon the face) what stricken with paralysis of the vocal chords. is at first but a slight blemish may become the doctor quickly stabbed the crico

most repulsive disfigurement, The smallest nevoid fleck of infancy, requiring and inserted a goose-quill thru the open

thyroid membrane with his pocket-kuife only the simplest measures for its effacement, may become of such size in later life ing. This allowed the patient sufficient as to require a serious surgical operation tracheotomy could be done. A hairpin

air to keep him alive until a deliberate and be followed by an unsightly scar. The bent at right angles one-half inch from the simplest and the safest method for the cure of small nevi upon portions of the body which to keep the lips of a tracheotomy

free ends is a useful instrument with where scarring is to be avoided, is by the wound apart, and two of them bent as use of the galvanic current. sponge electrode, thoroly moistened, is retractors at the blunt ends may be sponge electrode, thoroly moistened, is attached to tapes, past around the neck, placed upon some indifferent portion of

and made to serve the purpose of a trachethe body and connected with the negative conducting cord, and a properly insulated otomy tube for many hours. needle introduced beneath the skin (near the vessels which feed the nevus), and The tyro often manifests his sappy juve.connected with the positive pole. A cur- nility by the assurances of perfect success rent of from fifteen to thirty milliamperes which he lavishes upon his patients.


Fortunate the doctor who is an expert ence. The conditions obtaining in miliin parrying the “ leading question” when tary and in civil life are so different that prudence demands. Suppose a patient

Suppose a patient rules formulated for the one condition suffering from Colles' fracture should hook will not hold good for the other. The this kind of an interrogation point around soldier seldom suffers from an overloaded your neck : “Doctor, will I have a perfect stomach, and the civilian seldom allows arm ?"

Instead of indulging in mono- that viscus to become empty. In the one syllabic fatuity, one would better say, “ If case there would likely be no leakage from proper apposition of the fragments is the injured stomach, while in the other it maintained, and nature is successful in would certainly occur. The condition of her reparative efforts, you will have a use- the patient, his surroundings and the ful limb." This will indicate that you are ability of surgeon to do clean work will trying to establish an equal and perpetual always count for more than any hard and partnership between yourself and nature, fast anatomical rules. and if the patient is willing to contribute his legitimate share towards the effort made to benefit him, then the tripartite

A most excellent filiform bougie is made surgical agreement between himself, nature by taking a piece of silver wire of proper and yourself will probably prove satisfac- length and holding the end in the flame of

an alcohol lamp until a small bead is tory.

melted upon it. An injury to the lower end of the radius in a person under twenty years of age may be a diastasis instead of a Colles' fracture. The chief symptoms to be relied upon in In such a case there is a possibility of dislocation of the humerus are the squaregreat retardation in the growth of the ness of the shoulder, caused by the prom. bone in its length, from injury to the inence of the acromion process; the angle epiphyseal cartilage, as the upper extrem- formed at the insertion of the deltoid ; the ity grows in length mostly from the upper prolongation of the axis of the humerus epiphysis of the humerus and the lower leading away from, instead of toward, the epiphysis of the radius and ulna.

glenoid cavity ; feeling the head of the To secure success in the use of coapta- bone in its abnormal situation, and the tion sutures it must be remembered that inability to place the elbow against the their function is simply retentive. If any chest when the hand of the injured side is strain is placed upon them relaxation sut- upon the opposite shoulder. ures should be so placed that all tension is relieved.

One of the most markt advances re

cently made in orthopedic surgery is that Bleeding from the nose may usually be of tendon implantation. By this opera readily controlled by placing a tampon of tion a part of the tendon of a healthy iodoformed, or sterilized, gauze in the muscle is implanted into the tendon of a anterior nares. If the bleeding be from paralyzed muscle in such a way as to rethe posterior nares a double thread is

store the function of the disabled part. easily carried thru the nose into the

In such case we have muscular action to throat by attaching it to a soft rubber

proxy. The happiest effects of this newer catheter. The thread is now drawn out

surgery have been noted in cases of infälle thru the mouth and the distal end tied to

tile spinal paralysis. Of all the muscles a tampon, when the catheter is withdrawn in the body, the one most frequently par from the nose and the proximal end of the alyzed are those supplied by the perona! thread tied around a tampon at the anter- nerve and its branches. Most of the ior nares. In case no catheter is to be tendons of these muscles are readily acobtained, a probe, piece of wire or a hair- cessible to operation. In paralytic pin can be made to serve its purpose. In equino-varus the method of tendon imno case should cauterizing injections be

plantation has been particularly efficaciouused to stop hemorrhage from the nose. and the benefits derived from restorin

the functions of a paralyzed hand har The advice to avoid abdominal section

seemed little less than marvelous. in all gun-shot wounds of the abdomen above the level of the umbilicus, seems to There are numerous anatomical protes be discredited by accumulating experi- against the amputation of the leg for ir

jury to the popliteal artery or vein. The such cases are exhaustion from prolonged older surgeon lost sleep because he feared suppuration, and pulmonary tuberculosis. secondary hemorrhage; but the newer On account of their giving little pain, surgeon knows that secondary hemorrhage and being so innocent in appearance, both rarely happens in clean wounds. In the patient and the inexperienced physiwounds of either of the vessels mentioned, cian are likely to be deceived into a fatal ligatures should be placed upon both sides delay. Thoro extirpation of the growth of the wound and within half an inch of before dissemination of the bacilli has the lesion. This more surely conserves taken place gives the only hope of rethe channels thru which the redeeming covery. . collateral circulation is to be establisht, and adds nothing to the dangers of the case, provided the treatment is proper in

Surgical Hints. other respects.

In all amputations, remember that the Prominent among the measures to be loose muscles retract more than those carried out must be placed the postural which are attacht to the bone. Hence treatment. If the artery is injured, the it is better to sever the loose muscles first, limb should be lowered and artificial heat and the attacht ones next, so that the applied to the leg. If the vein is injured, ends may be of equal length. . the limb is to be elevated and gentle up- If you believe that your operation has ward-friction massage applied to the thigh. been a clean one, leave the wound alone, if A moment's study will reveal the reasons not an infected one. The best surgeons why by these means the forces of the usually apply but one dressing, the first. blood stream will be best conserved for When this is removed the stitches are the restoration and preservation of the taken out, and the wound only needs a parts. Do not think of amputation until the clean covering for a few days. evidences of gangrene evidence the folly of fur- Before giving ether to patients suffering ther delay.

from catarrh of the nasal passages, wash

these out with an alkaline solution. This A ganglion was formerly supposed to be will, by cleaning out the secretions, allow a sequestration from the synovial mem- much easier breathing, and hence increase brane of a joint or tendon sheath. Later the facility with which anesthesia can be investigations seem to prove that it is a induced. cystoma, arising from gelatinoid degenera- Scalp wounds should always be stitcht, tion of tendon sheath or the para-articu- if of any size. But always remove the lar tissues. The benign form of ganglion stitches very early ; otherwise they may is single, usually of globular form, and act as setons, and lead to suppuration, rarely exceeds an inch in diameter.

which if it reaches the loose layer under The older method of treatment by sub- the aponeurosis, is likely to be serious. cutaneous rupture was generally success- These wounds only gape if the scalp or ful, but the most approved treatment is muscle or its aponeurosis is incised, and extirpation. As a rule, such an enlarge very few stitches are needed. ment is simply an inconvenience, and is In cases of felon, find out as soon as seldom painful unless the contents become possible whether

possible whether the bone is attackt. infected.

Should the terminal phalanx become loose, In markt contradistinction to this inno- amputation will nearly always give the cent growth is the condition known as most useful finger, especially to workmen. compound ganglion. Compound ganglions The amputation, however, is best delayed are fusiform in shape, and are often mul- until the septic process is overcome, or tiple. Both growths have their usual hab- else the flaps will probably die, and the itat in the region of the superficial tendons time needed for healing by granulation of the wrist or ankle,

will be greater than that taken up in Compound ganglion is a tubercular teno- previous antiseptic treatment. synovitis and requires early and thoro In bad cases of frost-bite of the hands eradication. The injection of irritating or feet, do not be in a hurry to amputate. solutions is tinierous folly. Those cases Rest in bed and the most careful asepsis which are not subjected to radical treat- will often allow you to save fingers and ment frequently extend their infection to toes that would be sacrificed otherwise. the contiguous joints or to the lungs, so The asepsis must be thoro; shreds of that the more common causes of death in necrosing tissue must be duly removed, and the patient's strength be upheld by

the American Academy of Medicin. Containing the pro

nunciation and detinition of over 26,000 of the terms used in careful nutrition. Under such conditions, medicin and the kindred sciences, along with over sixtyer

tensive tables. Second edition, revised. Publisht by W. B. if gangrene becomes establisht, it is

Saunders, 925 Walnut street, Philadelphia, PA, 1199.' Price, usually found that the line of demarcation $1.25 net. is much farther towards the extremity

This little book is 3x64 inches, and inch

thick. It weighs but 7 vunces, and will readily than was anticipated.-International Jour.

fit any coat or trouser pocket. The first edition of Surg.

only lasted six months, and in the preface to this

edition the author says it is his aim to make Peanuts as Absorbents.

the book represent, as far as possible, the present Peanuts have a faculty for absorbing respects thoroly up to date.” This he has done.

state of medical lexicography by keeping it in all alcohol and preventing it from demoraliz

His experience as a teacher has aided him in the ing the nerves and upsetting the thinking selection of words and the elimination of useless machine. It is estimated, for example, padding found in many more pretentious works. that if a man drinks a quart of champagne

The book is bound in dark red Russia leather, and eats a pint of peanuts, the peanuts good, and the book will bear usage. It will be

with handsome gold title. The workmanship is will overcome the inebriating quality of

used by the medical student most extensively: the wine without entirely curtailing its yet the most of us could drop it into our pockets exhilarating effects. The large propor- occasionally, with benefit. It will not disappoint tion of oil in the peanuts accounts for this

the most critical purchaser who buys it for what result. A good wineglassful of olive oil

it claims to be-an up-to-date pocket medical

dictionary.-A. L. R. has the same effect. -Prac. Rev.

Blake on the Hand, or the study of the band for indics.

tions of local and general disease. By Ellward Blake. M.D. WORLD one year and Dr. Waugh's book, $5. You need them Publisht by Henry J. Glaisher, 57 Wigmore street, Careudis both.

Square, W. London, England. Price, half-a-crown, Del.

This little monograf is very readable, and furBook Reviews.

nishes many valuable hints; tho the subject is

treated quite fully in this country, in our large An Epitome of the History of Medicin. By Roswell Park, text and reference works on diagnosis. The A.M., M.D., Professor of Surgery in the Medical Department book contains thirty-seven pages, besides numerof the University of Buffalo, Based upon a course of lectures delivered in the University of Buffalo. Second edition.

ous bibliographical references and an index. It Illustrated with portraits and other engravings. The F. A. has four elegant plates and six cuts illustrating Davis Company, Philadelphia, New York, Chicago. Price.

the text. It will furnish any practitioner a $2 net. This book past thru its first edition in less

pleasant and profitable hour. The general getthan a year. It is gotten up in the usual elegant

up of the monograf is good ; it has been carefully Davis style-paper good, typographical work of a


and the typography is perfection itself.

A. L. R. high degree of excellence. Beside correction of a few minor errors appearing in the tirst edition,

The Mechanics of Surgery; comprising detailed descrip

tions, illustrations and lists of the instruments, appliances a chapter on “Iatrotheurgic Symbolism," cover- and furniture necessary in modern surgical art. Br Chares ing twenty-two pages, has been added. This Truax, Chicago. Price, $4.50. From medical book seilers, a

direct from the publisher. chapter is a historico-critical supplement to the main body of the work. In his preface to this

The work is a large-sized quarto, containing

1,024 pages, and 2,381 illustrations. The paper edition the author hopes “that a larger and

is good, and every illustration distinct. While more comprehensive work may be the outcome of

not by any means an encyclopedia attempting to interest in the listory of Medicin.” To this

illustrate and describe all the appliances used in sentiment his readers will respond, “Amen, and let Park write it.” The book contains 36.5 pages,

surgery, it covers the field well. The hypocriti.

cal reader who searches for his favorite instru. in XXV chapters. There are fifty-six illustra

ment, or the enterprising surgeon who has made tions. The history of medicin has been divided

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known instrument (bearing his name, but with

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authorship and publication are unique. It is selwork of this character is impossible. Suffice it

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sion enters the field of medical or surgical auwithout this work, and that a man will be a bet

thorship, and yet the particular field covered ter doctor for knowing something of the history

holds at this time no modern competitor. Inof the art he has espoused. Dr. Park has the

strument catalogs have appeared from time to faculty of adding zest to even the more interesting portions of medical history, and, at the lines, but they have either been so markedis

time aiming somewhat along the same genern. same time, the ability to make even the dullest

commercial in instinct as to render them valueparts pleasingly readable.-A. L. R.

less as guides, or they have been made up with a The American Pocket Medical Dictionary. Edited by W. A. Newman Dorland, M., M.D., Assistant Obstetrician to

context wholly in quotations. This work, en the Hospital of the University of Pennsylvania ; Fellow of the contrary, seems free from commercial taini.

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