His experiments may be arranged in three groups:

I. Botanical and bacteriological.

II. Upon animals.

III. Therapeutic.

I. Methyl violet (and by this he refers to the entire group of aniline substances giving a violet color) proved most efficacious in arresting the development of bacteria. In a strength of 1-500 or 1-1000 it prevented the formation of fungus upon moistened bread, fungi and the bacteria of putrefaction being much more resistant to antiseptics than the ordinary pathogenic bacteria which require definite conditions for their development, and are therefore less valuable as tests. The development of mycelium in sweetened beef gelatine was arrested by strong solutions of methyl violet. Without enumerating his experiments in detail, suffice it to say that solutions of the strength of 1-3000 absolutely prevented any development of mycelium in sweetened beef extract, even when the latter was artificially infected and exposed to the air. Putrefaction did not occur in solutions of 1-2000 even after prolonged exposure at a favorable temperature, and it was therefore assumed that weaker solutions would suffice for the less resistant pyogenic cocci. This was found to be the case, cultures of staphylococcus pyogenes aureus, etc., being deeply colored and showing no further growth when sprinkled with methyl violet (1-64000). Other aniline colors, as fuchsin, methyl blue, vesuvin, rhodamin, etc., proved less effective. Fermentation was also notably checked by solutions of 1-1000 and arrested by stronger.

II. When instilled into rabbits eyes a solution of 1-1000 caused intense coloration of conjunctiva and sclera, and also to a less degree of the iris, the cornea remaining clear as long as the epithelium was intact. Twenty-four hours sufficed for the color to entirely disappear. Methyl violet introduced in substance into the conjunctival sac produced considerable general coloration and the precipitation upon conjunctiva and cornea of a substance having a metallic lustre. Subsequently the epithelium became detached in large scales which showed. under the microscope a surprising fatty degeneration, almost similar to that from phosphorus. At the same time the scales like the entire conjunctival sac were free from bacteria. Other mucous membranes were similarly affected. In many cases there was produced in the human eye a dilatation of the pupil without weakening of the accommodation. Subcutaneously large quantities (20 cubic centimeters or more of 1-1000 solution) were borne without harm by rabbits and guinea-pigs, unless injected into the peritoneal cavity. Here over

10 c. c. produced disturbance, and if in large quantity, death. At the autopsy the abdominal contents, intestine, liver and kidney were col

ored intensely blue, the blood, however, being normal; and microscopical examination showed that even in organs deeply colored the vessels remain intact. This curious effect gives rise to a very beautiful appearance in the kidney, where the deep blue cortical canaliculi present a marked contrast to the glomeruli with their tufts of red bloodvessels. It is true that one sees in the living human eye that the aniline penetrates the vessels, but it is evidently rapidly disposed of without producing any alteration in the blood itself. Death probably ensues from coloration of important nerve centres and consequent paralysis. Autopsy shows no trace of serous exudation or inflammation, the abdominal cavity being rather dry. Methyl violet could be habitually eaten by rabbits in their food in large quantities, in grammes even, without harm, the fæces being intensely blue. Animals killed under such circumstances showed on the following day moderate coloration of the intestinal tract. Considerable quantities may be injected into the lungs of rabbits without causing trouble. As, however, many of the aniline substances contain arsenic, care must be exercised that the preparations employed are pure.

III. Stilling has used with success solutions of methyl violet in numerous corneal ulcerations with or without hypopyon, even when careful treatment with the accepted remedies had failed, and states his belief that it will soon replace the galvano-cautery in the treatment of corneal ulcers. He has also obtained good results in conjunctival and lid inflammations. But it is not alone the external inflammations of the eye which are amenable to treatment with aniline. Parenchymatous keratitis and serous iritis, even those severe forms of long duration with marked scleral inxection and diffuse vitreous opacities, were rapidly and markedly benefitted. Even in certain cases of disseminated choroiditis, its use has been followed in a few days by an astonishing and permanent improvement of visual acuity. The action of the aniline is explainable by its ready diffusibility, it traversing the sclera to the choroid as readily as it does the cornea to the iris. It was also of service in a pronounced case of sympathetic ophthalmia which had resisted atropine and mercurialization, instillations of methyl violet (1-1000) producing a prompt and continuous improvement. Injec tions into the vitreous did no harm and clearly arrested in rabbits panophthalmitis artificially excited by inoculation. Trials in the domain of general surgery showed the efficacy of aniline against all forms of suppuration, provided the remedy was allowed to penetrate thoroughly; and Stilling therefore recommends the aniline colors as perfectly appropriate antiseptics in surgery, obstetrics and gynecology.

In operations, solutions of 1-1000 may be used for the instruments, 1-2000 or weaker for the wound. Sutures should be impregnated

with 1-1000, and gauze or cotton likewise impregnated may be used as dressings. When suppuration exists the technique has to be modified to suit the case, use being made of injections, crayons or powder, or strong solutions painted on the part. A slight inconvenience attending the use of methyl violet is the consequent staining of hands and fingers, which, however, can be immediately removed by the use of alcohol or Labarraque's solution. On the other hand, the staining shows the extent of the sterilized area. Other uses of the antiseptic will suggest themselves, but it is in every case necessary to examine and carefully select the material employed. There are many kinds of methyl violet differing in composition and effect. Many among them, as above stated, contain arsenic or phenol, and can produce marked irritation, while pure methyl violet causes at the most but slight irritation when applied to mucous surfaces in substance or concentrated solution. Merck, of Darmstadt, has, at Stilling's suggestion, introduced, under the name of pyoctanine, suitable methyl violet for antiseptic use.

GYNECOLOGY.

BY WALTER B. CHASE, M. D.

TREATMENT OF UTERINE FIBROMATA.

The "Gazette de Gynécologie," May 1, 1890, contains an essay by Dr. Geo. Gautier, submitted to the Academy of Medicine, Paris. For seven years he has used Apostoli's method of intra-uterine treatment by chemical galvano-caustics. In 67 patients with uterine fibromata he applied galvanism 1,329 times. In this number were four cases of malignant disease. The earliest evidence of improvement are noticed, the abatement of pain, and diminution of hæmorrhage. He states Apostoli's method has been used 20,000 times in more than 2,000 patients, in Europe and America, confirming the claims made for its efficacy.

RUPTURE OF THE VAGINA FROM COITUS.

In "Centralblatt f. Gynaekologie," No. 22, 1890, Dr. Himmelfarb, of Odessa, discusses the question of rupture of the vagina. After a careful search of the literature and his own experience, he concludes that, while labor is its most frequent cause, the remainder of cases is less frequently due to introduction of foreign bodies than violent coitus.

Rupture of the vagina in old subjects during connection is well recognized. Frank and Zeiss have recorded and H. relates another where, in a healthy woman, aged twenty-four, parametritis, peritonitis,.

and fatal pyæmia followed coitus, in which the posterior vaginal wall was torn through.

Frank, of Hague, reported two cases to the German Medical Association last autumn: One a patient thirty-two years old; she recovered. In the second case there was vagina duplex; the right half ended in a blind sac, the left extended to the uterus; the hymen on the right side and the septum were lacerated.

INFECTIOUS ENDO-METRITIS.

Currier ("Transactions of the Medical Society of the State of New York," 1890, p. 191, on the "Rational Limitation of Uterine Therapeutics") says of the treatment of the infectious variety, particularly gonorrhoeal, the indications are for the use of a germicide, and that the nitrate of silver (a solution 3 j to j) is most satisfactory.

66

TREATMENT OF CYSTITIS IN WOMEN.

The Medical Press and Circular," July 2, 1890, contains a paper by Dr. Thos. M. Madden. After mentioning his remarkable success in its management, its ætiology, and the treatment, which first should consist as far as possible in the removal of the cause, he concludes that the method suggested by Sims and adopted by Emmet, in securing drainage and rest of the inflamed viscus, by the formation of an artificial vaginal fistula, is less effectual and less simple than thorough dilating of the urethral canal to a degree paralyzing its contractility, which may be repeated as often as necessary.

In exceptional cases he would curette the endo-vesical mucous membrane with a blunt wire curette, or brushing over its surface with diluted carbolic acid until the morbid sensibility is overcome-two or three applications, at an interval of a week or two, sufficing for a cure.

ARISTOL IN GYNECOLOGY.

Dr. von Swiecicki ("Medical Chronicle," July, 1890) reports a trial in twenty cases, including endo metritis, cervical hyperplasia, eczema vulvæ, parametritis, etc., in which he records highly satisfactory results. It was applied as powder.

DIAGNOSIS AS RELATED TO DISEASES OF WOMEN.

Prof. Wm. Goodell says, in the "Philadelphia Medical News," December, 1889, concerning the differentiation between disease and that of neurotic origin:

"From a large experience I humbly offer to the reader the following watch-words as broad helps to diagnosis:

"In the first place, always bear in mind what another has pithily said, that 'woman has some organs outside of the pelvis.'

Secondly. Each neurotic case will usually have a tale of fret or grief, of cark and care, of wear and tear.

"Thirdly. Scant or delayed or suppressed menstruation is far more frequently the result of nerve-exhaustion than of uterine disease.

"Fourthly. Anteflexion per se is not a pathological condition. It is so when associated with sterility or with painful menstruation, and only then does it need treatment.

"Fifthly. An irritable bladder is more often a nerve symptom than a uterine one.

'Sixthly. In a large number of cases of supposed or of actua} uterine disease which display marked gastric disturbance, if the tongue be clean, the essential disease will be found to be neurotic; and it must be treated so.

"Seventhly. Almost every supposed uterine case, characterized by excess of sensibility and by scantness of will-power, is essentially a neurosis.

"Eighthly. In the vast majority of cases in which the woman takes to her bed and stays there indefinitely, from some supposed uterine lesion, she is bed-ridden from her brain and not from her womb. I will go further, and assert that this will be the rule, even when the womb itself is displaced, or is disordered by a disease or by a lesion that is not in itself exacting or dangerous to life.

"Ninthly. Groin-aches and sore ovaries are far more commonly symptoms of nerve-exhaustion than of disease of the appendages.

"Finally. Uterine symptoms are not always present in cases of uterine disease. Nor when present, and even urgent, do they necessarily come from uterine disease, for they may be merely nerve-counterfeits of uterine disease."

ANALGESIC POWER OF ANEMONINE (ANEMONE PULSATILLA).

Dr. C. Bovet is quoted ("Therapeutical Gazette," July, 1890) of attributing to this agent pronounced analgesic properties, when administered in reflex painful affections of the uterus, from diverse pathological causes, which accompany menstrual pain, whether dysmenorrhoea or amenorrhoea, or whether from metritis, parametritis, or ovaritis.

He has used it in thirty-four cases. Twenty-two were difficult menstruation without discernible cause, eight of metritis, and two each of ovario-salpingitis and uterine prolapse, in which he states the pain. was relieved within forty-eight hours. The ordinary dose was one-sixth grain anemonine, administered in red wine.