bled through the fluid, the needle was moved slightly, until this sign of having penetrated into the air-channels was observed. In the treatment of the cases of phthisis some good effect was temporarily produced in two cases; but, on the whole, the results were not encouraging. Apart from the danger of accident, such as hemorrhage or pneumothorax, the procedure is somewhat alarming and disagreeable to the patient. The ethereal solution was very painful, and the olive-oil emulsion was so viscid that a larger needle had to be used than was absolutely safe. The solution of iodoform in oil of eucalyptus was the most satisfactory of all the mixtures that were tried. THE USE OF SPLEEN-PULP IN ANEMIA. MARAGLIANO has reported the results of his experiments with spleen-pulp in cases of impoverished blood and the conditions depending upon it. The pulp was given with an emulsion of bitter almonds in accordance with the following formula: R Emuls. amygd. amar., 3x; Spt. vini gallici (cognac), ii. This amount was given in twenty-four hours with meals. The diet consisted of soup with rice, or bread, at eight o'clock in the morning; a second soup, with four ounces of meat and bread, with a glass of wine, at noon; and a third soup at six in the evening. Five cases of chlorosis were treated in this manner, with the result, in from eight to twenty-five days, as follows: increase of general strength, increase of red blood-corpuscles; rapidly restored functional activity of the nervous, digestive, circulatory, and urinary mechanisms; increase of arterial tension and body-weight. The number of cases is manifestly too small for accurate results, but sufficiently large to awaken interest in the mode of treatment.-Deutsche MedizinalZeitung, January 3, 1887. AN EXPERIMENTAL RESEARCH UPON RABIES. At a meeting of the Philadelphia Academy of Surgery, held February 7, 1887, DR. HAROLD C. ERNST, of Boston, read a paper on the above subject (Medical Times, February 19, 1887). His experiments were performed with three objects in view: first, to determine whether or not there was such a thing as a virus of rabies; secondly, if there is such a virus, does drying at an even temperature modify its strength? thirdly, does the inoculation of such modified virus afford immunity against the inoculation of a stronger virus? The different series of experiments relating to these various points were then given in detail. The animals used in most of the experiments were rabbits, although guinea-pigs and dogs were also employed. The following conclusions were reached : 1. That there exists in the cords and brains of animals inoculated in Pasteur's laboratory a specific virus capable of the production of similar symptoms through a long series of animals. 2. That these symptoms are produced with absolute certainty when the method of inoculation is by trephining the skull and injection under the dura mater; with less certainty when the inoculation is by subcutaneous injection. 3. That the strength of this virus is lessened when the cords containing it are removed from the animals and placed in a dry atmosphere at an even temperature. 4. That the symptoms produced by the inoculation of this virus only appear at a certain period of incubation, distinctly shorter when the inoculation has been done by trephining than when done by subcutaneous injection. 5. That injections of the virus modified in strength by drying, and in the manner prescribed by Pasteur, exert a very marked protective influence against an inoculation with virus of full strength. 6. That a very moderate degree of heat destroys the power of the virus entirely, whilst prolonged freezing does not injure it. AN UNUSUAL CASE OF ACUTE INTOXICATION FROM MORPHINE. SCHEIBER, in the November meeting of the Society of Physicians of Budapest, reported the following interesting case: A neurotic woman, aged 54, suffering from a severe neuralgia, was given in three days' time of a grain of morphine hypodermically. After taking the last injection she passed into a deep sleep, which persisted forty-eight hours, during which she exhibited the following symptoms of severe morphine intoxication: convulsive movements and cy anosis in the face, dry tongue, loud tracheal râles, dyspnoea, perspiration, incontinence of urine and of fæces, subnormal temperature. The patient recovered in the main in three days, but exhibited for six weeks the following symptoms: aphasia, agraphia, alexia; a small bed-sore upon the buttock, and a small dry crust upon the right heel; entire amnesia; disturbances of mind, which showed themselves in irritability, childish movements, and deceptions of the senses. The neuralgia of the right lower extremity disappeared, as did the most prominent nervous disturbances after galvanization of eight days. Scheiber attributes the symptoms in the case to acute morphine intoxication followed by profound disturbance of nutrition, and well-marked cerebral hyperæmia and capillary apoplexy.-Centralblatt für Nervenheilkunde, January, 1887, No. 1. RECTAL INJECTION OF GASES IN DISEASES OF THE LUNGS. The Paris correspondent of the British Medical Journal, February 12, 1887, writes that at a recent meeting of the Biological Society, allow free expansion of the intestines, and the operator must carefully note any resistance to the entry of the gas, so as to allow absorption to take place during the operation. The breathing should be watched, especially when the pulmonary lesions are extensive, as any deficiency in respiration will make the elimination of the gas correspondingly difficult. Moreover, the substance used in the above experiments on the dog is not the same as that employed in pulmonary affections. In the latter case, the gas which is injected is a mixture of carbonic acid and sulphuretted hydrogen, and possesses properties very different from those of sulphuretted hydrogen alone. When intestinal irritation takes place, it is because the gases are not properly mixed. M. Peyrou injected into the dog twenty-five, thirty-five, ninety, and even one hundred cubic centimetres of sulphuretted hydrogen dissolved in a considerable quantity of water. In man, the quantity injected is not more than twenty-five cubic centimetres. M. Morel then described an apparatus for making these injections, the chief objects aimed at in its construction being to prevent any atmospheric air from mingling with the sulphuretted hydrogen and carbonic acid, to moisten the gaseous M. MOREL Commented on M. Peyrou's ex-mixture, and to prevent too great distention periments on the effects of the rectal injec- of the intestine. tion of sulphuretted hydrogen in dogs, and compared the doses with those employed in the treatment of tuberculosis. One hundred and fifty cubic centimetres of a saturated solution of sulphuretted hydrogen were injected in two doses at intervals of three minutes. Symptoms of poisoning began to be manifested within two minutes, and death took place in ten minutes. Another dog died quickly after two injections of the same strength, given at intervals of twelve minutes, while two others, in whom only very small quantities of the gas, or large quantities very much diluted, had been injected, experienced only slight inconvenience, and rapidly recovered. M. Peyrou concludes that sulphuretted hydrogen is harmless only when injected in small doses. With regard to these experiments, M. Morel observed that the quantities injected were enormous, being ten or fifteen times as great as those employed in man; and, supposing the dog to be four times lighter than man, the dose injected in the dog was really forty or fifty times as great as that employed in man. M. Morel then described in detail the mode of proceeding in the treatment of tuberculosis. The patient should be placed on his back in a position to LEAD-POISONING FROM CHOCOLATE WRAPPED IN TIN-FOIL. JOHANSON, of St. Petersburg, writes of the frequent use of tin-foil as a wrapper for chocolate, cheese, tea, tobacco, and other articles, and refers to cases already in print in which poisoning from the lead contained had occurred. The need for sanitary inspection and regulation in the sale of such articles is evident. A certain per cent. of lead in tin-foil is recognized as permissible, according to Hegar 6.6 per cent., while others give fourteen per cent., while an overweight of tin will cause lead to be absorbed by the material which is enclosed by the foil. In these cases paper is generally interposed between the foil and its contents. Johanson took three samples of chocolate from St. Petersburg manufactories, two of which were carefully separated from the foil by paper, and examined the chocolate by boiling one gramme with diluted nitric acid, and treating the filtrate with sulphuric acid and alcohol, when the lead present was pre cipitated. The two packages of chocolate wrapped in paper as well as in foil gave an amount of lead sulphate equal to 94.1 per cent. and 94.6 per cent. of the metallic lead; the chocolate wrapped in tin-foil only gave .7 per cent. of lead. As all three packages came from the same factory, it was evident that the dealer had purposely separated the cheaper foil from the chocolate by paper. The use of paper is not a sure protection, however, for chocolate is seldom free from water, and when kept for some time the water may penetrate the paper, and oxidation, the formation of salts, solution and the deposition of lead in the material enclosed follow.Pharmaceutische Zeitschrift für Russland, Jan. 11, 1887. TRANSPLANTATION OF TENDON FROM ANIMAL TO MAN. The Paris correspondent of the British Medical Journal, February 12, 1887, refers to a note by M. PEYROT on the transplantation of tendon from an animal to man. The patient, a boy, aged 14, entered the Hôtel Dieu in October, 1885. Six months previous to that date, he had received a wound on the palmar aspect of the first phalanx of the left middle finger, near the groove between the first and second phalanx. The flexor tendons were completely divided, and the finger was forcibly drawn back by the extensors. Simple suture of the two ends was out of the question, on account of the great length of time that had elapsed since the infliction of the injury. On October 30 an incision was made over the first phalanx in its palmar aspect, extending into the palm of the hand for a distance of about four centimetres. The ends of the tendon having been found with some difficulty, a piece of flexortendon thirty-three millimetres in length was taken from the hind paw of a young dog, and united to the vitalized ends of the divided tendon by three stitches of catgut. The incision itself was brought together by two rows of stitches; a deep one, near the transplanted tendon, in order to form a sheath, and a superficial one, in the skin. The operation was done with the most minute antiseptic precautions. When the first dressing was removed, ten days after the operation, it was found that there had been no suppuration; but unfortunately union had not taken place. There was, however, no sloughing, and the wound healed well. When the patient left the hospital on January 4, 1886, he had regained the use of all the fingers of the injured hand, In the Indian Medical Gazette for December, 1886, MR. S. J. RENNIE reports four cases of dysentery, the first three being subacute and chronic, and the last of the acute form, in which cure resulted from the administration of tincture of cannabis indica, even after ipecac with opium, Dover's powder, nitrate of silver injections, and various other modes of treatment had failed. Mr. Rennie first tried the officinal tincture in doses of 20 minims three times daily, but he has since found that this dose sometimes produced slight toxic symptoms, and he has consequently reduced the quantity to 15 minims, and prescribes it according to the following formula: R Tinct. cannabis indicæ, mxv; Misce, et adde Tinct. zingiberis, mxx; Spt. chloroform., mxx; Aqua cinnamom., ad Zi ter die sum. Even in these doses it is necessary sometimes to order it to be taken after meals, as it occasionally produces vertigo. It is pleasant to take, and there is no subsequent nausea. The administration requires to be kept up for several days after all symptoms have ceased. PERSISTENT VOMITING AS A CAUSE OF EAR-TROUBLES. Vomiting is not usually included in the list of causes which occasion catarrh of the middle ear. It is well known that aural affections frequently complicate general wasting diseases, especially in their final stages. The pharyngeal muscles waste along with the body, and the sufferer's last days are aggra vated by distressing tinnitus and vocal reverberation. Whenever any movement occurs in the throat, nose, or mouth, the sound is conveyed to the tympanum up the unduly patent Eustachian tube, causing an unnatural ringing and roaring noise in the ear. Added to this cause, MR. CHARLES ATKIN (British Medical Journal, February 12, 1887) suggests that while undue patency of the Eustachian tube will in many cases account for the symptoms complained of, the impaction of minute particles of regurgitated food or mucus in the tubes during the act of vomiting may also serve to produce aural complications. In the simple act of vomiting the contents of the stomach are not unfrequently ejected from the nostrils, and the tubal orifices may easily become plugged. Should the act be repeated constantly, as often happens in all renal and cerebral affections, the plug may be driven still farther up, until it becomes lodged at the narrowest part, at the junction of the cartilaginous portions with the bony part of the tube. Mr. Atkin reports two cases in which such a complication occurred. The right ear, and then the left, became successively affected through the plugging of the tubes. SURGICAL TREATMENT OF HYDATIDS was regarded as a very safe and efficacious procedure. The author recommended certain precautions to be taken when the cyst-wall appeared so thin that a needle - puncture might cause effusion of hydatid fluid into the peritoneum. Some modifications introduced with a view to meet special circumstances were discussed. The case of a young woman who had a hydatid of the liver which had been punctured eight times, and on whom the author performed the above-mentioned operation, was related. After a time eighteen hydatids and the wall of a large mother-cyst were passed from the wound. There was an absence of peritoneal symptoms, and the patient made an easy recovery. MR. W. HAWARD considered that the character of the contents of the hydatid cysts should determine the nature of the operation. Doubtless a free opening would be required if the contents were thick and compounded of daughter-cysts. He criticised Mr. Barwell's method, and thought that the potassa fusa caustic was to be selected, rather than the one which Mr. Barwell advised. His remarks were illustrated by cases. In one instance a second cyst was found bulging into the first, which had been emptied. second one was also opened through the first, but still the patient did not recover, and finally died with lardaceous disease. Hydatids were found in the omentum and spleen, and a suppurating cyst in the back of the liver, which was doubtless the cause of the continued illness and lardaceous disease. Altogether the method of gradual perforation of the abdominal wall, so as to secure proper peritoneal adhesions, was to be preferred to other methods. MR. HOWARD MARSH had successfully At a recent meeting of the Royal Medical and Chirurgical Society MR. RICHARD BARWELL read a paper on widely incising, by a two-stage method, hydatids of the liver (Lancet, January 29, 1887). Hydatids of the liver may be treated surgically by (1) puncture with a small trocar, (2) evacuation with a large persistent opening, and (3) electroly-practised the operation recommended by Mr. sis. This last has not commended itself to the judgment of the profession. The author recommends that the first method should always be primarily resorted to, chiefly because it sometimes is curative,-viz., in cases of single barren cyst; but in a large proportion of cases there are numerous daughter or secondary cysts, and then the tumors frequently recur. Under such circumstances the most efficacious treatment is by keeping a large opening patent for some time. The object of the paper was to point out the safest way of making such an opening. After discussing certain other methods, it was shown that incising the abdominal parietes first, then stitching to them the cyst or its surroundings, and finally cutting into the tumor after a few days, Barwell in one case recently. The sutures had to be passed into the substance of the liver because the hepatic peritoneum was so thin. The suppurating hydatid cyst was incised four days afterwards. In a case of suppurating hydatid cysts of the liver in a little child, an abdominal section was made without attempting to secure adhesion between the liver and abdominal wall. The result was satisfactory, and the case not complicated by the extravasation of the contents of the cysts into the peritoneal cavity. MR. HARRISON CRIPPS Considered that the free incision enabled the surgeon to deal with multiple cysts, which, in his experience, were frequent complications of hydatids of the liver. A case illustrating the advantage of a In this instance free incision was mentioned. special precautions with a view to obtaining adhesions were not used. A second cyst was completely emptied through the wall of the first cyst, which had also been completely evacuated. The results were perfectly satisfactory. SIR DYCE DUCKWORTH had seen good results after all the methods of treatment for hepatic hydatids. He was doubtful of the excellency of the advice that all the contents of the cyst should be evacuated at the surgical operation. It was still a point for the surgeons to decide whether the cysts should be completely cleared out, and whether antiseptic injections should be practised. MR. WALSHAM remarked that surgical treatment of hydatid cysts was not always of a harmless nature. A few cases of sudden death, even from aspiration, had been recorded. Perhaps this was due sometimes to hydatid fluid escaping into the venous circulation. He could not but think that an incision four inches long would be attended with some danger. In several cases of the kind he had made the incision from an inch to an inch and a half in length, and found this size ample for all purposes. There was but little fear of pus or hydatid fluid escaping into the peritoneal cavity, and he thought that excellent results could be obtained without the surgeon first endeavoring to secure adhesions of the cyst to the abdominal wall. After evacuation of the contents the cysts should be well syringed with carbolic acid solution, and then powdered by iodoform. In his own practice the wounds healed under this treatment with the best possible results. DR. ANGEL MONEY said that a continental surgeon was operating by abdominal section on a case of hydatid of the liver when the patient suddenly fainted and died. A daughtercyst must have escaped from the liver and entered into the hepatic vein, for one was found free in the right auricle of the heart. In MR. A. PEARCE GOULD thought that aspiration should be tried first in all cases. It was still an open question as to what was the best means to be adopted even in aspiration. Should the surgeon remove all the hydatid fluid obtainable, or only a small quantity? Perhaps the latter method was the safer. one case that had been under the care of Dr. C. Y. Biss, in a woman aged 40, Mr. Gould made an incision through the right linea semilunaris, when peritoneal adhesions were found, and four quarts of pus and hydatid cysts evacuated. The patient began retching, and the omentum protruded at the lower part of the wound. In the omentum abortive hydatid cysts were seen, but the omentum was easily returned and the sinus eventually closed. In a second case there was a very large hepatic tumor, from which reddish serous fluid, without hooklets, was drawn off. After incision two pints of fluid flowed out, and a large quantity of solid material was discovered. Some days later much of this material was scraped away, and some bleeding resulted. The case had now almost completely recovered. He was strongly in favor of the knife as against caustics. He did not think it was necessary to stitch the wall of the cyst to the abdominal wall before opening the tumor. MR. HENRY MORRIS supposed that the chief point for discussion in the paper was the necessity or not of a double operation. In a work of Dr. W. Thompson, published in 1841, on diseases of the liver and biliary passages, four methods of treatment were fairly stated. Some quotations were made by Mr. Morris from an article published in the Madras Quarterly Medical Journal for. 1839 by an Indian surgeon, in which the opinion was expressed that there was not much danger of effusion into the peritoneal cavity in opening abscesses of the liver. The plan of attaching the cyst to the abdominal wall was perhaps associated with that of gastrostomy and colotomy, but the procedures in the three cases were altogether different; for in the two latter operations a mobile and contracting organ had to be dealt with. In hydatids of the liver it was necessary to obtain a sufficiently large opening to allow of the escape of bulky contents. It was not difficult to secure coaptation of the cyst to the abdominal wall, and thus to prevent the escape of fluid into the peritoneum. Manipulations were also possible by which this coaptation could be secured at the time of operation. He thought that there was no necessity for a division of the operation into two stages. He could not think the procedure of Mr. Harrison Cripps-of removing the entire mothersac-an advisable one. Once, when tempted to perform this, he had in his recollection the case recorded by Dr. Bright, in which the stripping of the parent membrane from the adventitious coat was followed by hemorrhage that nothing succeeded in stopping. Once also a boy was run over and died. It was found at the necropsy that a hydatid cyst of the liver had become detached from its adventitious capsule, with consequent fatal extravasation of blood between the true and |