plethysmographic method of experimentation is a valuable one for determining the exact action of drugs on the circulation, and one that deserves more attention than it has hitherto attracted. not confuse him with new treatments until we were quite sure that they were new. He had worked much with fixed dressings and varnishes, and some years ago had described such a varnish as had the reader of the paper. He was glad to confirm the reader's claim regard A NEW METHOD OF TREATING DISEASES ing the utility of the emulsion-dressing, but OF THE SKIN LOCALLY. In the Section in Dermatology and Syphilography DR. VALENTINE KNAGGS, of London, England, proposed as a substitute for ointments the employment of emulsions, which, upon drying on the skin, form protective films. He had employed these dressings for the past two years with gratifying results in eczemas and other non-specific exudations. The inunction of the body with fixed oils has been found of immense service, but they are not adhesive, and exuding fluids readily escape from the surface. There are two methods of rendering oily substances adhesive, -1. Ву adding to them resinous, gummy, or alkaline substances tances; 2. In making use of gums to combine or emulsify a fat with water. Adhesive preparations, unlike oils, tend to arrest skin-action. Thus tar, varnish, or collodion form an impervious covering. Ointments to which adhesive substances, are added diminish skin-action, but do not abolish it. Well-made emulsions resemble milk or cream, are soluble in watery fluids, and are markedly adhesive, and are made by combining an ointment-basis with water, a vegetable gum, and a suitable antiseptic. Thus the formula preferred would read : The author called especial attention to the fact that all lint and textile dressings could be dispensed with. He did not expect these gum emulsions to displace older methods, but that they would serve a useful purpose. In discussing the paper, DR. UNNA said that we were now in the period of transition, making our annual change of treatment. It was very well for us as specialists to discuss new treatments, but we should not give them to the general practitioner until we were quite sure that they were good, and especially should could not concede to him that it was new, as there are many other varnishes made with gums and fats. He did not believe that any varnish which is soluble in water can prevent a great amount of evaporation from the skin. A NEW METHOD OF TREATING THE VEGETABLE PARASITIC DISEASES OF THE SKIN. DR. H. J. REYNOLDS, of Chicago, Ill., read a paper with the above title before the Section in Dermatology and Syphilography, of which the following is an abstract: First, the parasiticide must be applied so as to reach the bottom of the hair-follicles in favus, ringworm of the scalp, and barber's itch. He proposed to apply the medicament to the diseased part and place over it the positive pole of an electric battery, and the negative upon some other part of the body, and induce the penetration of the solution to the deeper parts by a well-known law of electro-physics. He uses a battery composed of a large number of small cells, such as is used for the removal of hairs. The strength of the current must vary with the sensitiveness of the parts,-five to fifteen cells, according to the feelings of the patient. Where there is much hyperæmia the current must be weakened. Cocaine, applied in this way, produces anæsthesia of the whole scalp. The surface is first to be thoroughly cleansed. Then saturate the sponge of the positive electrode with the parasiticide solution and place over the diseased patch, and the moist negative sponge over the skin of some other part of the body. A one per cent. solution of the bichloride was the parasiticide employed in the cases reported. He had only had an opportunity to thus treat three cases, but all have been so successful as to give him great confidence in its usefulness. RECENT VIEWS AS TO THE PATHOLOGY AND TREATMENT OF TUBERCULOSIS OF THE LARYNX. MR. LENNOX BROWNE, of London, read a paper before the Section in Laryngology with the above title. The tubercular bacilli are generally ad mitted as a cause of specific laryngitis. En- They must have an unhealthy or abraded surface on which to locate and thrive, and are prone to choose some weak point. Whether carried by the air, sputa, lymphatics, or general circulation, cases are recorded of infection through wounds and teeth that have been extracted. The author of the paper quoted cases confirming the same. It is well established that tuberculosis is a blood-poison, as are pyæmia, septicæmia, and the like. Germicides should be used, and benefit will result. He places great confidence in atropine, not only as a sedative, but as a germicide as well. Arsenic often works in the same manner as does mercury in syphilis. So, also, do the salts of calcium, where there are tubercular deposits. The aniline treatment has not been a success, and the gaseous injections are still on trial. Experiments with sulphuretted hydrogen show temporary improvement, with diminution of the amount of sputa expectorated, less pain, and less distress from persistent cough. Still, the permanent benefit is doubtful. This treatment needs careful supervision, and should not be trusted to the patients or their friends. The local treatment of tubercular laryngitis gives the best results, especially where systemic treatment is also employed to maintain health and nutrition. Use cocaine, and employ the galvano-cautery or lactic acid to destroy the deposits and induce healthy healing of the parts. The state of the health and the assimilation of food, together with tissue-nutrition, have more to do with the development of tuberculosis than have locality or climatic conditions. Not only may we have laryngeal is in proportion to their accessibility. tuberculosis as a secondary infection, but we find cases where it is primary. The laryngeal symptoms may be the first to attract attention, and even become far advanced before pulmonary lesions can be detected. This is confirmed by many observers. The bacilli are recognized in the sputa, there is pain in the larynx, and difficult deglutition. The larynx presents the specific appearance. We find the infiltration, swelling, and ulcers, but still can detect no pulmonary lesion. There must have been some neglected chronic laryngitis, or some solution of continuity when exposed to the presence of these germs. Cases are reported where these local symptoms have yielded to treatment before pulmonary complications were added, and the patients were discharged apparently cured. Treatment. Where the general system is not broken down, or the disease advanced to the lungs, sea- or mountain-air and high altitudes, especially in pine regions, are of vital importance. Oxygen, pure air, and the absence of germs are here more to be relied on than the thermal or climatic agents. Dr. Moore has ceased to advise the inhalation of medicated steam, but prefers oxidizing agents. Inhalations of vapor from turpentine, oil of eucalyptus, and menthol he has used with success. Where the infections are local, our success He does not like iodoform or iodol dissolved in ether, as the ether is too much of an irritant, and prefers a brush made with cotton to the spray, in that it coats the surface better and is pressed into folds which are protected from the spray by the spasm of the larynx. The continued use of the spray he considers dangerous to the ciliæ of the epithelial cells. Local and systemic sedatives are emphatically called for. Insufflation is not as good as where emulsions are made with acacia, as it is apt to form cakes. Cocaine gives temporary relief, but morphine, belladonna, and balsam are more permanent in their relief of both pain and cough. The surgical measures are to scrape away the deposits with curette or forceps, under cocaine, and apply lactic acid. Do not stab or incise; it may relieve tension and congestion, but is bad in that it gives new foci for infection. For the same reason it is better not to remove glomerulata unless respiration is seriously interfered with. Tracheotomy, for the purpose of giving rest to the larynx, is useless, and worse. The larynx does not then receive the necessary air and oxygen, and bacilli-infected mucus accumulates. The cold and dry air irritates the lungs and may induce pulmonary complications. Besides, the wound may become infected. Intubation of the larynx likewise causes too Important Suggestions.-1. Early diagnosis and treatment. 2. Do not be carried away with new remedies. 3. Never be too active | deine has the same constitution, and this body The first effect of the calomel is to empty the ❘ iodoform would be the best substance to embile-ducts and get a large flow of bile, and relieve the congestion of the liver and intestinal vessels. The second effect is due to the solution of the mercurial in bile, as pointed out by Headland, and this probably acts as an antiseptic in the bowels. The object is not simply to purge the patient, but to obtain a copious bilious discharge from the action on the liver. Where the tongue was most coated he got the best results. He believed that patients are killed by the use of opium and astringents. much irritation and aggravates the trouble, independent of the risk of blocking up the tube. Even refrain from removing an elongated uvula. He does not approve of the recent suggestion of extirpating diseased portions. Many apparent cures are reported, and he has had such cases himself, but is inclined to doubt their permanence. We can improve the condition of the larynx, stop pain and cough, cause better assimilation of food, and improve nutrition. There result local relief and apparently satisfactory results, but scarcely a cure, as claimed by Schmidt, Bosworth, and others. addition bodies. It is at present generally held that the substitution of methyl for hydrogen in an alkaloid causes the latter to act like curare, no matter what its original action may have been. The addition products, however, are very different in action from the substitution products. The formula of morphine is C1H, NO, (OH)2, and it contains, therefore, two molecules of hydroxyl. It is the hydroxyl-hydrogen atoms which are replaced most easily by alcohol radicals. With regard to the action of morphine it may be divided into two stages,-(1) narcosis, succeeded by (2) tetanus. Methylmorphine, C11H19 (CH3) NO3, is morphine in which one H has been replaced by CH1. Co 18 in destroying tissue; heal instead. 4. It is better to observe facts and be influenced by the experience of many, than by the new ideas of the few. ON THE PHARMACOLOGY OF SOME BODIES DERIVED FROM MORPHINE. DR. RALPH STOCKMAN, of Edinburgh, read a paper with the above title before the Section in Therapeutics. The experiments were conducted jointly by D. B. Dott, F.R.S.E., and Ralph Stockman, M.D. The relationship between chemical constitution and physiological action must always be a subject of deep interest to pharmacologists. In this short paper they proposed to mention briefly the changes in action resulting from various modifications in the constitution of morphine. How, in 1854, by acting on morphine with methyl iodide, obtained a body which he named hydriodate of ethylmorphia, and which he regarded as a substitution product, the methyl iodide being supposed by him to replace one of the hydrogen atoms in morphine. In the light of our present chemical knowledge How's body may be regarded as an addition product, iodide of methyl (CHI) being simply tacked on to the morphine molecule. In 1869, Crum Brown and Fraser investigated this body among others, and showed that the original action of morphine is quite lost, and a curare action substituted in its stead. From their nomenclature there can be no doubt that these observers regarded such bodies as addition and not as substitution compounds. Notwithstanding this, the authors find that in all text-books and reference-books these substances are always named and described as if they were substitution and not 18 is simply codeine prepared artificially from morphine. The action is exactly the same as that of codeine derived directly from opium. Ethylmorphine, C14H1 (C2H3)NO,, has the same action exactly as methylmorphine. Acetylmorphine, C12H2(C2H2O)NO3, and diacetylmorphine, C12H28 (C2H2O), NO, have a similar action to the two preceding bodies. That is, they produce narcosis in very small doses, which is followed by tetanus when larger doses are given. All these bodies are much more active than morphine, and smaller doses are required. In dogs, however, they produce much greater distress and much more marked vomiting and diarrhea. From examination of their action, the authors think that none of them is in a position to replace morphine clinically. SO-CALLED ANTISEPTIC ACTION OF CALOMEL WHEN GIVEN IN LARGE DOSES. DR. GEORGE S. HULL, Of Chambersburg, Pa., read a paper with the above title before the Section in Therapeutics. In cases of dysentery most prompt results in relieving tormina and changing the character of the stools were manifested. It acts as a cholagogue, producing a free flow of bile, sweeping out the contents of the bowel, and as a mercurial it exerts an antiseptic action. In cholera its usefulness in large doses has been advocated by some and denied by others. In the discussion the relative value of large and small doses of calomel was freely considered by the members of the section. In closing the discussion, Dr. Hull said that he was dealing with epidemic dysentery, and not with ordinary dysenteric conditions. ploy for injection into the parenchyma of the lung. The clinical utility of iodoform being the ground on which its use for this purpose has been founded, the evidence is not shaken by any statistics as to the comparatively feeble powers of the drug as a germicide. NOTES ON THE TREATMENT OF PHTHISIS, MORE PARTICULARLY THAT BY INTRA PULMONARY INJECTION. R. SINGLETON SMITH, M.D., London, F.R.C.P., Physician to the Bristol Royal Infirmary, England, read a paper on this subject before the Section in General Medicine on Thursday, September 8. Since the last International Congress at Copenhagen, in 1884, numerous attempts have been made to do more than had previously been attempted for a disease in which the vis medicatrix naturæ does so little. The reader of this paper briefly summed up the various methods which have been recently suggested since the discovery of the bacillus of tubercle, and expressed his belief in the possibility of benefit by treatment directed towards the destruction of the bacillary growth. He reported the result of his experience with regard to gaseous rectal injections, and said that in consequence of the absence of all indications of benefit he had given up this method entirely. He alluded to the work done by Professor Pepper, of Philadelphia, and Drs. Beverley Robinson and White, of New York. In carrying out the method of intra-pulmonary injections suggested by these and other workers he had met with partial success in a series of cases reported in the British Medical Journal of 1886. The insolubility of the drug is the chief difficulty; various solvents have been used, but with only partial success. Ether is objectionable because of its effects on the brain; giddiness and other feelings of discomfort rather alarm the patient, and give rise to an unwillingness to have a frequent repetition of the injections. Eucalyptus oil is irritating: two cases were mentioned in which acute pleuritis, with much pain, rise of temperature, and effusion had followed the injection of an iodoform solution in oil of eucalyptus. The vaseline oil, either alone or in combination with eucalyptol, had also been used, but the author still considers the question what is the best fluid to inject to be still unsolved. He did not advocate the use of solutions containing free iodine or bichloride of mercury, and he would not in future employ any fluid for injection into the lung which had not previously been tested hypodermically; if it gave rise to much inflammatory irritation in the subcutaneous cellular tissue, he would not venture to inject it into the lung. He was of opinion that injections into cellular tissue might possibly be of some little service, although there was as yet not much reliable evidence on this point, but they would serve as a reliable test whether any given fluid was suitable for deep intra-pulmonary injection. It is true that if iodoform be of use, as the clinical evidence indicates, then it is likely to be of far greater utility when injected, even in small quantity, into the focus of a diseased patch than when given in larger doses diffused throughout the whole body. Such injections have been shown to be not especially hazardous. Even the cases in which pleuritis has occurred had recovered completely from the attack in the course of a few days, and possibly the pleuritis was due to the failure of the fluid to pass beyond the pleural cavity into the lung-substance. Nevertheless, the author would not advocate the use of such injections in cases which were hopeless, neither would he employ them in cases where other and less active measures were accomplishing the object in view. He concluded his paper by urging perseverance in spite of as yet was only a tentative investigation would ultimately result in numerous and signal successes. In consequence of the proved utility of iodoform in chest-disease, as shown by a steadily-increasing mass of evidence since its first introduction for this purpose by Professor Semmola, in 1878, and supported by a series of cases presented to the International Congress of 1884, in which the author found increase of weight, improved appetite, diminution of temperature, and general improvement, under the administration of iodoform given by the alimentary canal, it was thought that | failure, and by expressing his belief that what DEVENTER'S METHOD OF DELIVERY OF THE AFTER-COMING HEAD. DR. JOHN BARTLETT, of Chicago, Ill., presented a paper with the above title before the Section in Obstetrics, supplementing the paper with a demonstration upon the phantom. neum. Deventer spoke in the most confident manner of the success and safety of podalic version, and of the ease with which the head could be delivered, but did not describe his method, which, however, Dr. Bartlett had found mentioned in Smellie's work. Deventer's method was shown to consist of a reversal of the socalled Prague method, in that the body of the child was carried far backward towards the perineum, with the view of turning the occiput out from under the pubes, the anterior surface of the neck resting on the periAt the beginning the occiput of the child was turned forward so as to come under the pubes as the child was drawn down. The arms were not to be drawn down, but left up alongside the head, being placed so as to come anterior to either parietal base. The delivery by traction backward upon the body was to be aided by pressure made immediately above the pubes, the wedge formed by the head and arms being decomposed by the withdrawal of the larger transverse diameter of the head from between the arms, as descent of the head accompanied by extension occurs. The mechanism was only favorable when the occiput was anterior. Deventer never lost a child or tore a mother. The arms, being left up, protected the neck of the child and allowed a passage for the cord alongside of them, so that haste was not as necessary as with ordinary methods, and, occupying a broad and yielding part of the pelvis, they did not obstruct delivery. The method was a plausible one, and certainly worthy of trial in suitable cases. THE CURABILITY OF DETACHMENT OF THE RETINA. PROF. X. GALEZOWSKI, of Paris, France, opened the session of the Section in Ophthalmology on Thursday, September 8, by reading a paper with the above title. He stated that the pathology of the disease is not entirely clear. The writer had observed in twenty years, among 152,000 persons, 789 detachments, of which 87 were in both eyes, 63 in emmetropic and hypermetropic eyes, and 194 were traumatic; 13 occurred after extraction of cataract, 18 were syphilitic, and 4 in sympathetic affections. Tumor was found in 10 cases. Twice only he found detachment in retinitis albuminurica, although he frequently saw this affection. Cataract is very frequent in detachment of the retina. Occasionally tearing of the retina is noticed, with the corpus vitreum introduced behind the retina, between the choroid and retina. He could say that the rupture of the retina is not so frequent, and considers it the consequence and not the cause of the detachment. Professor Graefe has said that the detachment is not curable, and the function of the retina is not restored. Dr. Galezowski had seen a case which showed alterations in the retina at the place of detachment, which had been completely cured. The patient gave the usual history of trouble with the vision, coming on suddenly and continuing for one or two or three months, with afterwards recovery of sight. He explained the appearance of the fundus as seen by the ophthalmoscope, and illustrated them on the blackboard. The conditions predisposing to detachment were said to be (1) choroiditis; (2) liquefaction of the corpus vitreum. In treating these cases he begins with antiphlogistic treatment, atropia, rest, etc., and he had in seven cases a complete cure, -the retina completely adherent, and around the line of the separation atrophy, with pigment-deposit and choroiditis disseminata. The first indication is antiphlogistics. Apply every month two, three, four, or five leeches, then atropine, and warm and cold compresses alternately, and in the intervals between the leeches he applies derivative plasters. Inside of five months he has completely cured detachment of the retina. Mercury and potassium iodide are also useful where exudation is present, or in cases of constitutional disease. Fifteen years ago he proposed iridectomy to stop the inflammation of the choroid, but it did no good in that way, although it stopped the iritis. Now he proposes a new operation. He considers the exudation behind the retina as being of the same character as the effusion in pleuritis or peritonitis, and has had an instrument (which he exhibited) made to aspirate the fluid. The instrument is a syringe with a stop-cock and an aspiratingneedle. He introduces the needle through the sclerotic at a considerable distance be |