tendons of the hand, more frequently the extensors these structures lined by mucous membrane there may than the flexors, forming what is called a ganglion; this be a development of a tumor of this kind. is a cystic tumor. Little bodies are frequently con- | The gelatinoid variety is most frequently founi in tained in cysts of this kind when large and of long the cavity of the nose; it is composed essentialy of celstanding. Such a tumor requires removal, but in the lo-fibrous tissue, the cavities or cells of which are more simple forms of the affection we make use of sub-filled with a sort of gelatinoid fixit, and it is covered cutaneous division, comminuting the sac in which the by a reflexion of the mucous membrane of the cavity in fluid is contained. which it is developed, having blood-vessei-, frequently of large size, straggling in their arrangement, and also nerves and absorbents. It is often pelinculated, that is, attached by a narrow footstalk, and has a free extremity. The cystic tumor of the scalp is always removed with the knife; it is not amenable to the absorbents. So with the cystic tumor in the inner surface of the cheek, in the labia, nymphe, vagina, etc. Sometimes we let out the contents and inject an irritating fluid-as dilute tincture of iodine, this producing odliterative inflammation. In other cases we are obliged to excise the tumor. The operation of ovariotomy has become fasnionable, and very justly so. When performed in cases properly selected, and well executed, and the after, treatment properly attende i to, the mortality is not any greater than from many other capital operations. XI.—HYDATIC TUMORS. The fibroid polyp is uncommon-liable to occur more particularly in the uterus, in the varina, and in the nose. In the latter situation it frequently assumes ma iznancy. Attached generally wherever it may occur by a broad base, especially in the nose, where it is adherent to the margins of the posterior nares, or the septum of the nose, liable to bleed, exceedingly tough, dense and firm. Such a tumor is an ugly growth, d felt of detachment, and exceedingly prone to take on malignancy when allowed to pursue its course. It is usually removed by torsion. It must be got rii of as early as poss bie. ment. The granular polyp is uncommon. It looks not unlike the lobes which enter into the composition of the parotid gland. It is most liable to occur in the uterus and vagina, and also in the nose: it is slow in its growth. The hydatie tumor is a very uncommon tumor; a! tumor produce by the presence of the hy dad, the acephalocysts, described by Laennec in the earlier part! The vascular polyp is usually connected, by a long of the present century. It may occur in the mammary pedicle, to the bowel. The operation for rs removal gland, the ovary, the liver, the subcutaneous cellular consists in seizing hold of it with a pair of forceps, and substance. You may have a solitary tumor, or num-twisting it off; or tying it close to its point of a tachbers scattered throughout the affected organ. Sometimes we find a number of these acephalocysts; rounded or globular bodies shut up in the same bag, cyst, or cavity. They are composed usually of two membranes, more or less closely connected together, transparent or translucent in the earlier stages, but becoming more: All these tumors are covered by a reflexion of the opaque as they increase with age. The inner surface is mucous membrane of the part to which they are atstudded with immense numbers of little bodies, not tached. larger than a grain of sand, distinctly cystic in their | character, and containing each one or more of those lit- The myeloid tumor is so called from its resemblance tle bodies called echinococci, a term signifying a spine. to the marrow of the bones-marrow-like originally When such a growth is situated in the mammary g and, described by Paget and by Lebert. It is found most there will be a certain degree of fluctuation, but that commonly to grow upon the surface or in the interior will not enable you to determine whether the tumor of the bones: sometines in the mammary gland, occais one of this character or whether it is an encysted sonally in the uterus or ovary, now and then in the tumor; and therefore you can determine the existence beutaneous or intermuseular celular tissue: it has of a growth of this kind only by an operation. So, also, been found in various parts of te body. Under the when situated in the ovary, only after the tumor is tap-microscope it is four i to consist of cells, some rounded ped, when the spices may be found in the flid by examination under the microscope. So if, exam ning urine, you find these bodies, you are certain that there is such a tumor connected with the kidneys. The proper remedy is removal. If left to itself, these structures at length perish, and in this way give rise to inflammation, followed frequently by the death of the individual. XII.-POLYPOID TUMORS. | XIIL-MYELOID TUMORS. or spherical, some oval, elongated or lanceolated, very smail, containing nuclei and nucleof. A section ecnsi-ts of a mass, marrow-like in its consistence, or of a sub!stance resembling tallow. It is highly organized, having large blood-vessels, nerves, and absorbents. It has no distinct envelope. The section of en presents a pecular pinkish or reddish appearance; now and then blotches of a livid aspect, characteri-tie, it is said, of this kind of formation. It grows rapidly, and is capable of acquiring a large bulk. When extirpated, it always returns. It is nothing but a modification of the ordinary encephalo d, or recurring fibroid tumor. THE DIFFERENTIAL DIAGNOSIS OF BENIGN TUMORS. A few general remarks on diagnosis will be much better than to individualize. The polypoid tumor is so called because it resembles a poly. Of this variety of tumor we have not less than four; for example, the gelatinoii or oyster-like polyp, which is the most common and the most simple. Then there is the fibroid polvp, resembling in its structure the fibroid tumor as already described, liable to take on malignancy. Then there is the vascular poivp. The hypertrophic tumor can generally be diagnostiThus, when there found most frequently in the rectum of young persons,cated from the history of the case. bleeding on the shrest touch, composed mainly of blood-vesseis, arteries, and veins, supported by connective or cellular tissue. Then there is the granular polyp, composed of a friable granular mass, found chiefly in the uterus and in the vaina These tumors occur in the ontlets of the body, the nose, ear, throat, larynx, œsophagis, stomach, bowels especially the rectum-vagina, vulva, uterus. In all is an enlargement of the tonsis, you cause the patient to open the mouth, depress the tongue, and look into the throat. The glands will present themselves increased in size, and increased in hardness: there are few cases where enlargement and induration do rot coexist. In regard to goitre, there is no difficulty in the dignosis; there is a tumor under the skin, which moves with the larynx. In regard to the vascular tumor there is no difficulty. Its color is always sufficient to enable you to distinguish between it and other morbid growths; it is reddish, or purple, or modena in appearance. Its consistence is always soft; and if it is aneurismal in its character, there will be an impulse or pulsation synchronous with the contraction of the left ventricle of the heart. The horny tumor can always be readily distinguished by its shape, consistence, and appearance. The fatty tumor has a softish, inelastic, doughy consistence; grows very slowly; is generally situated immediately beneath the skin, or between the skin and the muscles, or among the muscles; it never degenerates into malignancy; has no tendency to ulceration; there is no enlargement of the subcutaneous veins; no hardening. In regard to the fibroid tumor. This is usually slow in development, situated most frequently underneath the skin, or beneath the skin and among the muscles, and in the interior of the uterus; generally very slow in formation; very firm, dense, and resisting; seldom acquiring a large magnitude except when it occurs in connection with the uterus; no enlargement of the subcutaneous veins; no discoloration of the skin; usually circumscribed; sometimes movable, at other times confined or restricted in its movements. Reports of Hospitals. BELLEVUE HOSPITAL. LATERAL OPERATION FOR LITHOTOMY.-Three Inches of REPORTED BY CHAS. S. BULL, M.D., ACTING HOUSE-Surgeon. W. H, æt. 45, married, a native of the U. S., and by occupation a farmer, was admitted to Bellevue Hospital, Dec. 26, 1867. The patient stated that about three years ago he first began to be troubled with slight difficulty in micturition. He took no particular notice of it at first; but it gradually increased to such a degree, that life became a burden to him. He denied ever having had any venereal disease, and was unable to assign any cause for his trouble. About a year after this difficulty in micturition first appeared, a small swelling showed itself in the perineum, accompanied by pain and redness. It rapidly attained the size of a hen's egg, was opened, and pus freely discharged. He then passed most of his water The fibro-cartilaginous tumor, or enchondroma, varies through the fistula, and it was six or seven months bein consistence between the fibroid and the bony, par- fore the latter was entirely closed. The difficulty in taking of the character of both. It is also slow in micturition again returned, and he resorted to the use development, capable of acquiring large size, and usu- of a catheter to relieve Lis pain. Subsequently a small ally found in connection with the skeleton, sometimes fluctuating tumor appeared in the same place as the below the skin and among the muscles. The history previous one, which was poulticed, and discharged some of the case, the want of pain, and the absence of malig-pus, and soon healed. This time he did not pass any nancy will serve, along with its consistence, to illus- water through the opening in the perineum. trate its diagnosis. The bony tumor can always be readily distinguished by its form and consistence, and by its connection usually with a portion of the skeleton. The cystic tumor always fluctuates more or less distinctly under pressure. If any doubt remains, all we have to do is to use an exploring needle, and the escape of fluid will generally determine the character of the affection. It is slow in development, sometimes congenital, oftener acquired. The hydatic tumor has nothing of a diagnostic character during any stage of its progress. We can determine its existence when it occurs in the lung, kidney, or liver, by finding some of the hydatids in the expectoration, urine, or fæces; or if there is an opening in the wall of the abdomen, for instance, attended with discharge. In regard to the polypoid tumor, that occurs always in the outlets of the body, the nose, or ear, or throat, or maxillary sinus, or in the rectum, the vagina, or the uterus. Usually one can readily determine the nature of the case by inspection, and by means of the touch. The myeloid tumor I believe to be nothing but a variety of encephaloid, and its characteristics distinguish it. If you can remember these facts brought prominently before you, you will have little difficulty in arriving at a correct diagnosis. About the 1st of September, 1867, while using a small gum elastic catheter, the instrument broke off, leaving about three inches of it in the bladder. Since then he has suffered from symptoms of stone, and the difficulty in micturition has increased. On admission into the hospital, he was in a very low condition, being considerably emaciated, and his urine dribbling from him constantly. A No. 12 conical steel sound was introduced, but was arrested five and a half inches from the meatus. Nos. 11, 10, 9, and 8 were then introduced, but neither of them penetrated the stricture. No. 7, however, passed through it and entered the bladder. allowed to remain for a short time, and was then withdrawn and No. 8 introduced, which passed readily through the stricture. No. 9 was then with some little difficulty passed into the bladder, and on its withdrawal a few drops of blood followed. No further attempt was made to dilate the stricture. It was A consultation having been called, it was decided to operate on January 10, 1868. The patient was etherized, and placed in the usual position for lithotomy. Dr. Sayre performed the ordinary lateral operation, the incision being about two inches and a half in length. Some hæmorrhage occurred, which was readily controlled. On entering the bladder, a hard mass of considerable size was felt, lying transversely across the neck of the organ. A pair of lithotomy forceps were introduced and an attempt was made to remove the mass entire, but it was so friable that it had to be removed in pieces. It proved to be the THE CONDENSED MEAT FROM AUSTRALIA is beginning to remains of the catheter, which had become incrusted constitute quite an important article of trade, especially with the urinary deposits, but not throughout its whole with England. It is prepared according to Baron Lie- extent, for the incrustations formed a loop, extending big's formula, but on an extensive scale. The process from one end to the other, the central portion being free. consists in removing every morsel of fat, tendon, etc., The patient rallied well from the operation, and the the soluble matter of the meat itself being then ex-wound in the perineum healed very rapidly. A sound tracted by steam. The liquid thus obtained is dried by was passed on him every day, but the stricture has again evaporation to the consistence of extremely thick jelly. contracted, so as to admit only a No. 6 conical bougie. The man, however, passes a good stream, and but very little escapes through the wound. He was discharged February 3, 1868, at his own request. Progress of Medical Science. IDENTITY OF FUNGI OF FAVUS AND TENIA CIRCINNATA. -Dr. John M. Purser has a very able article tending to prove the above, in the last number of the Dublin Quarterly Journal of Medical Science. TUBERCULOUS INOCULATION.-Dr. Lebert, continuing his researches on this topic, has at length obtained positive results, having demonstrated it on the coelhos and porquinhos of India, which he inoculated with tuberculous matter. He afterwards found tubercles in the liver, spleen, pericardium, pleuræ, and throughout the entire lymphatic system, and a microscopical analysis demonstrated that these tubercles were the same as found in man.-Gazeta Med. da Bahia. THE CAUSE OF CARIES IN TEETH.-It has been established by an English surgeon (Dr. I. P. H. Brown) that this condition of the teeth commences to manifest itself in many women after fecundation, for, during that state, the mother is called on to furnish precisely this calcareous element, for the development of the foetal structure; and when this assimilating material is insufficient, the foetal organization must be supplied at the cost of the bone proper of the teeth-a material difficult of repair, but admitting of ready and rapid deterioration. Dr. Mayitot, in his new treatise on dental caries, demonstrates that the saliva of the mouth, in consequence of the change in its composition, in various diseases, as typhoid fever, dyspepsia, etc., exercises a hurtful influence, and is a true cause of dental caries.-Gazeta Med. da Bahia. CEREBRAL CONGESTION IN INSANITY.-M. Lisle regards arsenious acid, in doses of from five to sixteen millegrammes (from about one-tenth to one third of a grain), given three times a day before meals, as a specific remedy for cerebral congestion in insanity.-L'Evénement Médical. considerable quantity of bloody urine. The only way in which relief was afforded was by lying on the right side with the lower extremities drawn up. The case progressed favorably until the twenty-second day, when, the patient feeling so well and desiring to change his position, was soon after seized with internal hæmorrhage, from which he shortly after died. At the postmortem it was found that the liver had been ruptured, and its lacerated portion had been crowded through a rent in the right wing of the diaphragm in such a manner as to prevent accident, until it was dislodged by the unfortunate change in his position. The right kiduey showed a cicatrix of a recently healed laceration. A STUDY to Serve as a Basis for the Nosological Classification of a Special Epidemic of Paralysis prevailing near Bahia. The following interesting extract is taken from the able article of Dr. Julio Rodrigues de Moura, in the Gazeta Medica da Bahia (Brazil), of July 31st, 1867: An epidemic paralytic affeetion, which has been so prevalent of late in Bahia, and which is so identical with certain cases which I have observed in my own modest clinics, offers several points of observation and study. And since comparing my cases with those presenting similar symptoms noticed by the distinguished physician of the Hospital du Caridade, Dr. Silva Lima, who agreed with me in my opinion concerning this curious affection, I have determined, by the aid of my notes, and in consideration of the importance of the disease, especially when its general fatal termination is known, to cite the eases constitutThe doctor then proceeds to ing my experience. speak of the difficulty of a correct diagnosis in the cases, and of his own present state of indecision in regard to the disease, and then refers to the symptoms. He says: "The following symptoms are well marked: Gastric symptoins, as anorexia and vomiting, preceded and accompanied by a paralytic lesion, pains, resembling the phenomenon of muscular neuralgia, increased on pressure by walking, by any movement, and accompanied by an oedema, which gradually invades the lower extremities, then the superior, then the face, and then the entire body-a sensation of epigastric tightness, blunting of the cutaneous sensibility, an absence or diminution of the urinary secretion, and terminating finally in rapid sinking, anemia, typhous The doctor cites, symptoms, dyspnoea and asphyxia.' in this number of the Gazette, seven cases, in four of which death ensued, and in three of which a cure was the result. One of the latter is translated: C. J. d'A., aged forty-two, sanguine temperament, single, strong constitution, street-paver, and an inhabitant of Surnby. In February, 1866, he presented himself to me complaining of some trouble, which, he averred, he derived from serious thoughts! stated he had never suffered from syphilitic taint, nor from rheumatism, but was led to tell me of his having had a grave disease, resembling, from his description, pernicious fever, for which he had been treated. Shortly after his entrance, he complained of a muscular torpor and weakness, great difficulty of locomotion, especially when going upstairs. Edema of the lower limbs took A CURIOUS CASE OF RUPTURE OF THE DIAPHRAGM.- place, anorexia and moral apprehensions, then a feverish John D. Hill, M.R.C.S., relates the particulars of a flush passing up the spinal column. This patient was case which lately occurred to Mr. Marsden, that is in- much improved at once by the exhibition of potass. teresting in a clinical point of view. The patient was a iodid. taken in an infusion of lupulin, to which was male forty-six years of age, who was crushed by a mass added the syrup of codeia. At the same time, stimulatof earth while making an excavation. He was immedi- ing frictions were used, in which was the composition ately after extricated in a state of collapse, from which, of the English liniment of the tinctures of pepper and however, he subsequently rallied. During the first forty-nux vomica. The muscles soon acquired their natural eight hours he suffered from great embarrassment in breathing on the slightest motion, and also passed a DISCOVERY OF A NEW HUMAN PARASITE.-Dr. Judée reports in the France Médicale the discovery of a new parasite, which produces the same symptoms as the acarus of the itch; but essentially distinct in appearance. This insect is black, visible to the naked eye, and about the size of a punctuation point. There are no ridges on the skin as seen in the itch caused by the burrowing of the acarus. Examined by the aid of lenses and the microscope this new insect is found composed of a head armed with two antennæ, of an abdomen, and of four pairs of legs having each four joints. Examined with a power of one hundred and forty diameters, the body and legs are seen to be covered with hairs. The insect is destroyed and the eruption cured by the use of Helmerick's ointment, which contains sulphur and subcarbonate of potassa. "Case 3d. He strength, the oedema passed off, and finally the man was discharged well." Dr. de Moura lays great stress on the drowsiness and moral apprehension or timidity in which was a nodular swelling, the size of a nut, conoccurring in the course of the disease. taining clotted blood, and communicating with one of the large uterine vessels. LANCING THE GUMS IN CHILDREN.-Dr. F. H. Thomson (Glasgow Medical Journal), believing that the irritation of teething is caused by the engorgement of vessels supplying their circulation, advises the practitioner to cut low down at the reflected junction between the lip and the gum, instead of upon the summit of the gum itself. BISULPHITE OF LIME AS AN ANTISEPTIC.-According to W. S. Scott, F.C.S., the bisulphite of lime possesses the valuable property of arresting decomposition when added to mixtures. He uses it to preserve ointments from rancidity (a fluid drachm to the pound being sufficient for such a purpose), and also advises its employment with beef-tea and jellies for the same purpose. CAMP ITCH.-Dr. F. W. Hunter recommends the following as a remedy: Take four ounces of fresh May-apple root, put into one pint of water, boil down to two ounces, and add two ounces of lard, and half an ounce of tinct. iodine; scent with oil bergamot, q. s. Wash the affected parts with castile soap and water, and apply the ointment at once. Two applications will suffice.-Half-Yearly Compendium of Medical Science. CARBOLIC ACID AS A DRESSING FOR SURGICAL WOUNDS is becoming fashionable with surgeons. Used in the form of solution in water, in the proportion of a drachm to the pint, it is a valuable remedy. VULCANIZED INDIA RUBBER CATHETERS are used by MM. Rechet, Maisonneuve, and others, with good results. They seem to find their way into the urethra with the utmost facility, and cause no pain. GASTRIC NEURALGIA WITH ARSENIC.-Dr. Leared, of the Great Northern Hospital, strongly advises the use of arsenic, in the form of Fowler's solution, in such cases. The dose is from two to five minims thrice daily, after meals. THE MEDICAL USES OF CHLOROFORM.-In an article with the above caption in the Dublin Quarterly Journal of Medical Science, Dr. Charles Kidd, of London, gives a very interesting review of the uses of this anæsthetic. He is not a believer in mixed vapors, and is of the opinion that it is much safer to give ether or chloroform separately. As regards safety, he avers that chloroform will rank above all the other anæsthetics when used with care, forethought, and skill. He alludes to DECAPITATION IN CASES OF TRANSVERSE PRESENTA- the great benefit arising from its administration in the TION. Dr. Emil Meissner reports in the Wiener Medi- different affections hitherto regarded as intractable, cal Wochenschrift that out of 8,500 cases presenting such, for instance, as tetanus, hooping cough, gall-stone themselves at the clinic of Professor Spalth for obstetri-colic, hydrophobia, and for the pain occasioned by the cal attendance, the operation of decapitation was twice treatment of aneurisms by compression. He believes, performed. In both cases the internal os was so con- with Brown-Séquard, that chloroform proves fatal by structed that turning was impracticable. In one case active reflex influence, due to the sudden irritation of it was found necessary to crush the head with the cethe branches of the par vagum in the lung, at least in phalotribe before it could be extracted. In the remain- those cases in which the heart's action ceases before the ing case the head was extracted without much diffi- respiration. Death occurs only in the incomplete stage culty, by the forceps. Both cases made a good of the anaesthetic process, and not when motive power is abolished. recovery.-Half-Yearly Compendium of Med. Science. "In other words," says he, "in trivial operations mostly, and before the patient is well put TOOTH-ACHE DROPS.-The following is considered a under chloroform, the accidents have occurred. Almost very good application for cavities of carious teeth: like a nettle (unpopular as this idea may be), chloroEqual parts of creasote, laudanum, chloroform, tinct. form stings when lightly touched, causing laryngeal aconite, tinct. of iodine, and liq. plumbi subacetat. It spasm." is used upon a pellet of cotton. JOINT INFLAMMATION.-Mr. Barwell, Surgeon to Charing-Cross Hospital, is in the habit of treating cases in which the acute symptoms have subsided, with the applications of iodine and bicarb. of potash, also combinations of iodide of lead and iodide of potassium. The latter he considers as a most valuable absorbent in cases of strumous and rheumatic thickening. EXCESS OF UREA IN CERTAIN KINDS OF DYSPEPSIA.Dr. Fuller recently remarked before the Royal Medical and Chirurgical Society concerning the association of an excess of urea with certain forms of dyspepsia, attended with strongly marked nervous or hypochondrial symptoms. He believed that the urea was produced from the elements of the food during the primary processes of assimilation, probably as a consequence of perverted nervous action. TRAUMATIC ANEURISM OF UTERUS.-Dr. Graily Hewitt presented to the London Pathological Society a case of the foregoing. The woman was delivered with the forceps, and everything went on satisfactorily until the fourth day, when she suffered violence from a drunken husband, who knelt upon her. This was followed by a good deal of inflammatory action about the uterus, and hæmorrhage, which eventuated in her death at the end of the thirty-seventh day. A pouch was found at the post-mortem on the right side of the organ, REUNION OF AN AMPUTATED FINGER.-Mr. Walter Bernard, L. K. Q. C. P. (British Medical Journal), relates the case of a lad who had half an inch of his finger separated in an oblique direction through the nail by a circular saw. Although the patient was seen twelve minutes after the accident, the severed portion of the member, after having been cleaned of the dirt int which it had fallen, was accurately applied to the stump, and united after a time throughout its entire extent. TREATMENT OF MENORRHAGIA.-Dr. Murray, of the Great Northern Hospital, treats those obstinate cases of menorrhagia dependent upon enlarged uterus and granular mucous membrane with cotton plugs saturated with sesquichloride of iron, introduced into the uterine cavity. He allows them to remain in situ for 24 and 48 hours. HEARTBURN.-Dr. F. W. Pavy (Digestion and its Disorders) says, in speaking of this very common complaint, that rich living is a frequent source of its production. He is inclined to think that the burning sensation at the pit of the stomach is due to a retrograde flow of bile into the cavity of the viscus, but Dr. Leared believes it to be produced by butyric acid either taken with pastries or formed in the process of imperfect digestion. The treatment advised is mainly comprised in the administration of alkaline reagents. Society, Dr. Edward Jarvis, of Dorchester, read a paper on the "Effect of Condensation of Population on Life." After giving copious statistics to show the tendency of the population of all countries to centre in cities and large towns, and speaking of the increase of cities by condensation as well as by extension, Dr. Jarvis con A very useful form is a combination of carbonate of soda or ammonia with rhubarb and magnesia, or with rhubarb and calumba. Sometimes the liquor potassæ is to be preferred. The Seltzer and Vichy waters are sometimes very agreeable, and valuable as correctives. When of very long standing it is best relieved by dilute mineral acids, nitric being in most cases the pref-sidered the subject in its mortuary aspects. In many erable one. DELIRIUM TREMENS TREATED WITH CANNABIS INDICA. -Dr. Bedoe, Physician to the Bristol Royal Infirmary, advises, in the treatment of mania-a-potu, the employment of the cannabis indica. He usually begins with a grain of good extract or twenty minims of the tincture; waits from four to six hours, and then, if the patient be awake, gives a double dose. If this also prove fruitless, six hours later he gives three or even four grains; then allows six or eight hours to pass, and if necessary tries a yet larger dose. Longer intervals are obviously needful for extract than for tincture. In one case Dr. B. gave as much as six grains before the patient began to sleep. Along with the remedy he is accustomed to give as much soup, milk, and other digestible food as the patient's stomach will bear, and says that cannabis does not injure the appetite as does opium. He rarely gives alcoholic stimulants unless the pulse gives unmistakable evidence of its propriety. TREATMENT OF DISEASES OF THE HEART.-Dr. S. O. Habershon, Physician to Guy's Hospital (Guy's Hospital Reports, 1867), lays down seven principles of treatment for diseases of the heart: 1st, to lessen its work; 2d, to insure regularity of action in avoiding all excitement; 3d, to lessen the distension of the right heart by purgatives, diuretics, etc.; 4th, to prevent syncope, attendant upon exhaustion; 5th, to strengthen the fibres of the heart by suitable out-door exercise; 6th, to prevent fibrillation of the blood by suitable remedies, for instance, carbonate of ammonia; and 7th, to prevent secondary complications, such as pneumonia, pleuritic effusion, etc. cities, he observed, the deaths of natives annually exceeded the births of children of native parents. It was extremely rare to find a citizen of Paris with many generations of Parisians among his progenitors. London needed 10,000 recruits from the country each year to keep its number good. In speaking of the effect of condensation on the rates of mortality, Dr. Jarvis said the registration reports of England for thirty years showed an average annual mortality of 26 to 1000 in the closest districts, and 16 to 1000 in the sparest districts. The difference of mortality in town and country was not exactly proportional in all the causes of death. For instance, there was a much larger proportion of deaths by zymotic and nervous diseases, and diseases of the respiratory and digestive organs, in the city than in the country; while the proportion of deaths by old age was 37 per cent. larger in the country than in the city. The mortality of children was also greater in the city-the excess of deaths of children under five years, in English towns and cities, from 1851 to 1860, being 152 per cent. over the proportion prevailing in the country." In considering whether this excessive mortality in cities is inherent and unavoidable, Dr. Jarvis attributed much of it to the destitution and privation; the dangerous occupations and the protracted labors of many of the inhabitants of cities; the compactness, narrowness, and crookedness of the streets leaving little chance for the circulation of air; and the excessive mental exertion, and undue expenditure of the vital powers by the better classes. In so far as these causes could be removed, the rate of mortality would be lessened. Sanitary improvements in 19 towns and cities of Great Britain had A NEW FORM OF CYSTITIS.-Dr. Heller, in charge of the reduced the rate of mortality from 28 in 1000 to 21 in Pathological Chemical Laboratory of the Imperial Gene-1,000. In Liverpool the decrease was 30 per cent. The ral Hospital in Vienna, made the following communica- same might be done here, in Boston and New York. tion before the Society of Physicians of that city: In cases of vesico rectal fistula it not unfrequently happens that as, on the one hand, the urine flows into the rectum, giving rise to liquid stools; so on the other, fæcal matter finds its way into the bladder, and is found in the urine discharged. It has, however, escaped the observation of the profession up to this time that a form of cystitis exists, in which, with a completely closed bladder, fæcal matter shows itself in the urine. Heller has observed twenty cases, partly in hospital partly in private practice, where investigation showed fecal matter in the urine during life, and an autopsy discovered a normally closed bladder. According to his experience this form of cystitis occurs in certain inflammatory affections of the brain and spinal cord. The presence of fæcal matter in the urine will be apparent on treating it with concentrated sulphuric acid. An intense fæcal odor will thus be developed. He succeeded in these cases in separating the fæcal matter from the urine by the processes of distillation and filtering. According to Dr. Heller's observation, this urine, in comparison with that of other forms of cystitis, is less viscid and contains but little mucus or sediment. In all cases where such a cystitis (which he would call cystitis fæculenta) occurred, the prognosis was very bad and death soon supervened. Allgemeine Wiener Zeitung. CONGENITAL ATRESIA OF ANUS.-The Gazette Médicale of Strasburg, of May 25, contains an interesting paper in which is reported a case of congenital atresia of the anus, successfully operated by Prof. Rizzoli, of Bologna, aud communicated to the Society of Medicine of Strasburg by Prof. Stoltz. By an incision from the fourchette to the coccyx, the terminal enlargement of the rectum was exposed and separated by dissection, and also the little canal by which it communicated with the vulva. The posterior surface of the rectum was slit longitudinally. its inferior extremity completely isolated, drawn down and fixed to the integument at its proper place. LIGATURE OF FEMORAL FOR LACERATED WOUND OF KNEE-JOINT.-A case, at the London Hospital, of acute inflammation in and about the knee-joint of a male adult, who had sustained a lacerated wound of the joint, has been treated (at the suggestion of Mr. Maunder) by ligature of the femoral artery, with a view to modify the inflammatory action. "Thirty days," says the Lancet, "have elapsed since Mr. Little applied the ligature at the apex of Scarpa's triangle, and the case has hitherto progressed most satisfactorily. Mr. Maunder proposes also to ligature the brachial artery in cases of acute inflammation of the palm of the hand." EFFECT OF CONDENSATION OF POPULATION ON LIFE.- CORPULENCY AS A RISK IN SURGERY.-The over-fat At the recent meeting of the Massachusetts Medical | are certainly a bad class, especially when their fatness |