aware this was disputed, so would speak definitely. healthy locality. It is open daily for patients from 2 to The whole length of the urethra from the meatus to 4 o'clock P. M. The building is well adapted for an inthe caput gallinaginis was 74 inches. The stricture was stitution of this character, and undoubtedly two ad6 inches from the meatus, 1 inch from the ejaculatory joining houses will soon be brought into requisition, ducts. As the prostatic portion was normally 1 inches and connected with the main building by covered long, he believed this stricture must have been there galleries, on account of the increasing demand for new seated. It might be contended that it was at the junc-wards for patients, who are from time to time operated tion of this with the membranous portion; but it cer- upon and allowed to remain until cured. tainly was not in the spongy portion. A No. 1 sound would not pass through it; but a very slender instrument was passed; then a metallic sound; and, finally, a No. 1 laminaria bougie. In two hours this dilated the stricture from No. 1 to No. 4. The next bougie dilated to No. 5. An intermission of eleven days was allowed, during which the stricture contracted a little; but a No. 3 bougie, left in for three hours, dilated it to No. 8-a better result than he thought possible with any other bougie.

In the use of these bougies two or three points must be attended to. If the lower part of the bougie were allowed to pass into the bladder, this end might be so expanded by the urine as to make its withdrawal impossible. It was essential, therefore, either to varnish the end, or not to let it reach the bladder. The bougie should not be moved, after its insertion, to watch the progress of expansion. This was very irritating to the patient, and when finally taken out, it should be done The patient must be kept constantly under your own supervision.

at once.

In the first quarterly report ending July, 1868, the following facts are noted: Four hundred out-door patients were relieved during three months following its opening, beginning April 15, 1868; of which number two hundred and ninety-five were afflicted with diseases of the eye, and one hundred and five with diseases of the ear.

Patients suffering with catarrhal ophthalmia, granulations (trachoma), keratitis, and ulcer of cornea, amounted to twenty-five per cent. of the whole number of eye cases treated. Nine persons were relieved from blindness by surgical operations done in the waids.

Cases of chronic inflammation of middle ear, with or without perforation, and obstruction of Eustachian tube, comprised about fifty per cent. of the ear cases treated.

The Medical Officers are as follows: Surgeons-C. R. Agnew, M.D., D. B. St. John Roosa, M.D, E. G. Loring, M.D. Assistant Surgeons-A. Mathewson, M.D., H. G. Newton, M.D., O. M. Pray, M.D.

LONG ISLAND COLLEGE HOSPITAL.-After the recent

changes made in the faculty of this institution, it is com

ton, M.D., Professor of Surgery; Samuel G. Armor, M.D., Professor of the Principles and Practice of Medi cine, Pathology and Clinical Medicine; Corydon L. Ford, M.D., Professor of Anatomy. E. S. Dunster, M.D., Professor of Obstetrics and Diseases of Women Chemistry and Toxicology; Benjamin Howard, M.D., and Children; George W. Plympton, Professor of Professor of Operative and Clinical Surgery; Wm. T. Lusk, M.D., Physiology and Microscopic Anatomy. Andrew H. Smith, M.D., Materia Medica and Therapeutics.

DR. HOWARD-One mode of treatment consists not in mechanical dilatation, not in rupture, not in incisionit is not only a different procedure, but it involves a dif-posed of the following gentlemen: Frank H. Hamilferent principle. Sir Henry Thompson calls it " continuous dilatation," but it is not that. Instead of distending the stricture and so producing dilatation that may persist for a shorter or longer period, Mr. Thompson uses a catheter which he insists shall be much smaller than might be readily passed. This he leaves in the canal for two or three days, and then replaces it by a larger one, but still two or three sizes smaller than the stricture would admit. He cures his patient in ten days. The process induced appears to be one of slow ulceration; and if it be so, then it seems to me the cure is likely to be more permanent than by any other method. DR. CHADSEY related a case of much interest. He had, in 1844, been called a long distance from home to a case of retention from stricture, which was found impermeable. The patient was suffering intensely, and said he could not live till morning. In accordance with the heroic treatment of the time, he was bled a quart; but the stricture continued obstinate. An injection of warm oil into the urethra had no better effect. Having in his carriage a galvanic battery-the Pike's battery then commonly in use-the doctor determined to try its effect. Cutting off the end of a gum catheter, he passed it down to the stricture; and through this as a guide and insulator he introduced a knitting needle, which was made one pole of the battery. In twenty minutes after the current was applied, the stricture gave way; the patient was relieved, and finally made a full recovery. Dr. C. had pursued a similar treatment in some three cases since.

DR. GOULEY remarked that the last speaker might claim priority by several years, in the electrolytic treat

ment.

Medical Items and News.

THE BROOKLYN EYE AND EAR HOSPITAL.-This hospital is situated on the corner of Washington and Johnson streets, Brooklyn, L. I., in a central and

INFANT MORTALITY.-In the Vienna Medical Society, says the 10th June number of the Allg. Med. CentralZeitung, Professor Skoda brought forth some really fearful statistics of the foundling hospital in that city. From 1784 to 1866, 434,687 infants were received in that institution, of whom there died before their tenth year 315,323, about 78 per cent. What is more, so far from decreasing in later years, this mortality has been actively on the increase. From 1853 to 1866, the admissions were 127,183, of whom 101,922 have died, therefore more than 80 per cent.-Phila. Med. and Surg. Reporter.

THE INTERNATIONAL CONVENTION FOR THE CARE OF THE WOUNDED IN BATTLE.-The following additional clauses are to be added to the code adopted by the International Convention of August 22, 1864, for the care of the wounded in battle. The articles were adopted at Geneva, Switzerland, during the past month.

Article 1. The military hospital ships having on board the sick or wounded of the naval force which they accompany are protected by neutrality. This neutrality will cease if the said hospital ships have a military force beyond what is required for carrying out the police regulations of the service, or should such vessels have on board war material or provisions foreign to their equipments.

Pending and after an engagement, the small craft, which at their own risk and peril receive the drowning and the wounded and convey them to a hospital

the following conditions to be considered as neutral, A TREATISE ON THE DISEASES OF THE EYE, including the and respected and protected by the belligerents:-They must be provided with a commission, license, or safeconduct from their own sovereign, authorizing their employment as hospital ships, and also furnished with a document from the responsible naval authorities of some port, stating that such ships are under their control during their fitting out, departure, and return to that port, and that they have been employed solely in the service for which they were destined. These ships will be recognized by flying, in addition to their national flag, a white ensign with a red cross. These ships will aid and assist the wounded and shipwrecked of both belligerents, without distinction of nationality. They may not impede in any way the movements of

Original Communications.

THE LAW OF RAPE.

A PAPER READ BEFORE THE NEW YORK MEDICO-LEGAL
SOCIETY,

BY JACOB F. MILLER, Esq.

RAPE, from raptus mulierum, signifies the carnal knowledge of a woman forcibly and against her will. This crime has justly been regarded of an aggravated nature, and been visited with severe punishment. By the Jewish law it was punished with death in case the damsel was betrothed to another man; if she was not so betrothed, then a heavy fine of fifty shekels was to be paid to her father, and she was to be the wife of the ravisher all the days of his life without the power of divorce. "Because he hath humbled her he may not put her away all his days."

The Roman law punished the crime of rape with death and confiscation of goods. Stealing away a woman from her parents or guardians, and debauching her, was equally penal whether she consented or was forced. The Roman law entertained such an exalted idea of the sex, that it never supposed a woman to go astray without the arts and seductions of the other sex, and therefore by punishing so severely the solicitations of the men, it thought to secure the honor and chastity of the women.

injury may be threatened, and so through fear she may be easily overcome.

The act must be committed against the woman's consent. Children under ten years of age cannot legally consent, as they are incapable of judgment and discretion. In an English case (Russ & Ry. C. C. 489), it was held that if a woman be beguiled into her consent by artful means, it will not be rape; and having carnal knowledge of a married woman, under circumstances which induced her to believe it was her husband, was held by a majority of judges not to be a rape. In this case, the woman supposed her husband to be in bed with her, having fallen asleep with him in bed. She discovered by the breathing of the prisoner that it was not her husband, and immediately threw him from her. She then went and hanged herself, and was saved from death by the skill of her surgeon. It is difficult to see how her conduct can be tortured into consent. Fraud vitiates everything in which it enters. It may form the basis of a claim against the perpetrator of it, but never in his favor. Moreover, had the woman known the prisoner was there instead of her husband, he would not have accomplished his purpose. He should not be allowed to take advantage of his own wrong. Several of the judges intimated, however, that if such a case again occurred, they would direct the jury to find a special verdict, with the view no doubt of examining the law more carefully.

The crime is not mitigated by showing that the woman at last yielded to violence, if she consented through duress or violence, or threats of murder; nor The English law with less gallantry, but with will any subsequent acquiescence on her part remove more justice and good sense, refused to punish one of the guilt of the ravisher. Nor is it a defence to show the transgressors for what might have been a mutual that the female was taken at first with her own confault, and hence made it an essential element in the sent, if she was afterwards forced against her will, as crime of rape that it must be against the woman's will. she has a right at any time to withhold her consent. Rape was punished by the Saxon laws with death. The Roman law seems to have supposed that a This was afterwards thought too severe, and in the prostitute could not be capable of injuries of this chartime of William the Conqueror, the penalty was chang-acter. The reason was, that, as she had no regard for ed to castration and loss of the eyes. In the Third Edward I., the punishment was much mitigated, and the crime was regarded simply as a trespass, if not prosecuted by appeal within forty days, and subjecting the offender to two years' imprisonment, and a fine at the king's will. In the Thirteenth Edward I., the commission of this crime was made a felony, it being found that this lenity produced such disastrous conse

rape.

1. There must be carnal knowledge. 2. It must be done forcibly; and 3. It must be done without the woman's consent.

By the common law, to constitute carnal knowledge, there must be not only penetration of the body of the female, but also emission of seed. But offenders so frequently escaped punishment on account of the difficulty of proving the emission of seed, it was enacted in the ninth year of the reign of George IV., that the carnal knowledge should be deemed complete on proof of penetration only; and any penetration, even the slightest, should be deemed sufficient, even though not of such depth as to rupture the hymen. And even though the jury negative the emission, or the circumstances be proved to have been such that no emission did or could take place, carnal knowledge is complete on proof of penetration.

The amount of force required depends upon the circumstances of the case. It is not necessary that the female should put forth all the strength of which she might be capable on other occasions, as her fears may be aroused, she may think that her life is endangered,

her chastity, there was no crime in violating it. The common law, however, does not allow the forcing of a prostitute. It admits the possibility of her reformation, and gives her the power to withhold her consent. She has a right to her person and her liberty so long as she does not interfere with the rights of others.

Formerly it was held not to be rape for a man to have forcible connection with his concubine. This is so no longer. A man cannot be guilty of a rape on his wife, for the matrimonial consent cannot be withdrawn so as to make the act criminal; but he may be indicted and punished as an abettor. All who are present, of both sexes, aiding and abetting in the perpetration of the crime, are principals in the second degree. When several persons are engaged, though some of them only really commit the act, in the eye of the law, they have all participated, and all are guilty.

On a trial for rape the prosecutrix is a competent witness. In the case of a child of tender years, her whole story which she has previously told, should be received in order to test the accuracy of her recollection. The fact that a female made a complaint shortly after the crime was committed, can be proved; but not the particulars of the statement. Indeed it is important to inquire respecting the time which elapsed before she made her complaint; the state of her dress, the marks of violence upon her person; whether she called for assistance, if there was a probability that any one was near enough to render it. But delay to make her complaint will not prejudice her cause if she was under the control of the ravisher, or afraid of him.

As the charge of rape is easily made and hard to defend, and the prosecutrix is the main and frequently

the only witness, the law allows her character for chastity to be impeached. She may be asked whether she has not had previous connection with the prisoner or with other men, and in this case she is not privileged from answering. Generally witnesses are excused from answering questions when the answers would degrade them, but the necessities of the case here form the ground of the exception. She may be shown to be a common prostitute. For while a rape may be committed upon a prostitute as well as upon a virgin, yet the proof is quite different. It is easy to believe that a woman having frequently submitted to the lewd embraces of another, will readily repeat the act. There is a wide difference between a tenant of the stew," and the chaste female who instinctively shudders at the mere thought of pollution. It is much easier to continue a course of vice, than to commence it.

66

The character of the female, and the circumstances under which the act was committed, are important, as bearing upon the question of consent.

The punishment for having carnal knowledge of a child under ten years of age, or a female over that age if forced, is imprisonment in the State prison for a term of not less than ten years. The having carnal knowledge of a woman above ten years of age, without her consent, by administering any substance or liquid producing stupor or imbecility of mind or weakness of body, so as to prevent effectual resistance, is punished by imprisonment for a term not exceeding five years. Surely "the way of the transgressor is hard."

PHTHISIS, ITS CAUSES AND CURABILITY.
By C. BOTH, M.D.
BOSTON, MASS.

IV.

them, I must confine myself to a few remarks which, however, may help somewhat towards understanding the most necessary points which experience and calculation have taught me.

Having convinced myself that no acute inflammatory process is going on in the lungs, I consider the muscular power and capability of the thorax, and compare it with the pulse and condition of the patient; after that I endeavor to the best of my judgment to apply tension of the muscles without increasing the action of the heart more than ten pulsations. The slow bending backward and forward of the patient will of itself produce deeper inspiration. The different rotations of the humeral joints in connection with this are the means of deeper and forced inspirations without raising the pulse. All these motions must be executed very slowly and with a machinelike steadiness; the mouth open, and respiration being uninterrupted. I consider it advisable that a physician, desiring to try these exercises, should experiment upon himself first, and he will soon find by what means the best effect can be produced-the_object being to get the deepest possible inspiration. I begin, according to the case, with the simple raising of the arms until fatigue ensues; at the same time bending the body forward and backward; afterwards I allow the patients, in an erect position and with straightened arms and body, to lean forward in a corner of a room and raise themselves up again by the power of the pectoral muscles alone. This exercise is afterwards tried in a horizontal position upon two chairs; until I finally succeed in bringing them so far as to be able to bear almost the whole of the weight of their body upon the muscles of the chest without raising the pulse to any amount. The patients, having tried the exercise, should respire long and deep, and not short and quick; coughing is generally the result. After one or two days they will experience pain in the muscles which have been brought into play; and I have found that the more acute the pain the better does the case promise. It is a bad After a period of about a week expectoration will increase and become easier; the cough itself gradually becoming deeper, changing from a hacking into a pectoral cough. Excepting the pain in the muscles and more abundant expectoration, patients do not perceive much change before a period of from two to four weeks, when the thorax begins to become more elastic and the respiration freer. It requires generally some weeks to bring the patient so far as to enable him to perform these exercises easily, and yet with full benefit; at first all act awkwardly and strain themselves unnecessarily. I generally order these exercises thrice a day, sometimes oftener, and so as not to interfere with the meals. All exercises with heavy clubs or dumb-bells, running up stairs, long walking or walking too fast, fast driving, horseback-riding, dancing, singing, disputing, etc., are strictly forbidden. The use of rocking or easy chairs is not advisable. Patients should be taught to walk erect, sit erect, and when fatigued should always lie down. It is important that the attendants should remind the patients constantly as soon as they involuntarily fall into a stooping posture. When lying down they should be brought as much as possible into a horizontal position, the chest as elevated as advisable; they should invariably sleep on hair mattresses.

THE extension of the chest and the consequent restoration of complete respiration, by means of gym-sign if the muscles act as if they were partially paralyzed. nastic exercises and deep inhalations of air, would seem at first sight a thing easily to be accomplished. But its practical execution in the treatment of consumptives with a view to a correct result, not only requires much consideration but is attended, especially in private practice, with many difficulties which, although theoretically of but little importance, are practically sometimes almost insurmountable. And I should judge from my own experience that unless special attention is given to this point the results will always be unsatisfactory. It is necessary to use considerable pressure to force air into the diseased parts; but if we use too much press-, ure we produce congestion, and thus make things worse than they were before. It will be found that but little irritation is required to bring the action of the heart in consumptive patients to a fever height; the direct consequence of which is short breathing and oppression. By inhalations, excited by the will of the patient alone, we cannot force the air into the apices, in the achievement of which lies the desired result. The reason why no results, capable of permanently holding the attention of the profession, have, as yet, been achieved by respiratory exercises, although these have been recommended by many authors, is, in my opinion, to be sought in the danger of congestion, by applying too much force, and in the inefficacy of such exercises, by using too little. Yet, after an experience of ten years, I am confident that any physician who, with due consideration, patience, and time, gives his attention to it, will be rewarded with satisfactory results. It being impossible to give the exact manipulations, which I use for my patients, in writing, as well as I could show

All artificial inhaling apparatus or pumps are absolutely worthless for obtaining what we wish to accomplish, because they extend the free parts of the lungs and not the apices. The breathing under decreased and increased pressure of air, with or without artificial addition of oxygen, as used in Germany, may be useful under some circumstances; but I have no experience

in this method. Theoretically we might hope for good results from the artificial increase of oxygen-but I doubt if there should be a quicker oxidation of material than can be replaced by digestion. To treat tubercular lungs with vaporized liquids of strong character, chloroform, ether, prussic acid, etc., I consider very irrational. I have never used any means to subdue the cough or ease it with narcotics, as I do not find it necessary. The above-mentioned exercises secure all that can reasonably be expected under the circumstances, and exceed by far any means that have ever been used to comfort such patients. During a practice of ten years I have never used a grain of morphia to secure night-rest for consumptives, neither a mixture to ease or modify coughing. Coughing in consumption is as necessary as fever in pneumonia. I do not allow the wearing of respirators; only in case patients are obliged to walk against strong winds I should advise them to put their hand or handkerchief loosely before the mouth, so as to break the force of the wind somewhat. I order them to walk in the open air daily, without regard to season or weather; all that is necessary is to prevent their getting wet through. I never knew any of them to have been affected to disadvantage by gentle walking at any season. The raising of small quantities of blood, occasioned by the bursting of previously existing small varicose vessels, does not suspend the exercises. I have never experienced any bleeding in any of my patients, although I have commenced with these exercises directly after they had quite severe hæmorrhages. But I know that several patients who gave up my treatment after a short trial, have perished soon after of hæmorrhage. The pain experienced in the muscles and the greater expectoration made them afraid of my

treatment.

reddish color. But it varies frequently. An abnormal quantity of urine, or the existence of albumen in it, are bad signs. It but rarely shows a milky appearance; but often fat will be noticed in it; however, this is usually caused by their respective diet (cod-liver oil, whiskey, etc.). Sometimes it is colored by bilious matter. Lime, magnesia, and silica in the urine of consumptives are either absent, or they exist in very minute quantities.

Now, if we compare the state of the mouth, the craving after certain food, the peculiar digestive power of the stomach, the color and nature of the fæces, and the quality of urine, we can calculate very nearly as to the state of the liver, and the state of the blood generally. We should also not forget that next to the proportional quantity of the blood-material, the quality has to be taken into consideration. The fact that fibrine and albumen are very changeable in their chemical constituents, and of the blood-globules showing different vitality, is well known, and Lehmanns peaks of it especially; but I have not as yet seen or heard that much weight has been laid upon this fact in practice. The blood, under certain circumstances, contains protean combinations, which are absolutely different from fibrine and albumen, and of which we may say that they are imperfect or pathological products of the bloodfabricators, e. g. Leucin and Tyrosin. Probably owing to impaired oxidation generally, the carbon-combinations likewise form imperfectly oxidized matter, such as butyric acid, acetic acid, etc., which aid considerably towards the production of the severe night-sweats, if they are not their principal cause. Naturally it must be our object to remove these and prevent their further formation. A primary object to be gained is a greater activity of the liver, which is always more or less imaccomplishment of this is a greater quantity and better quality of bile. I do not wish here to state or argue the several views about the office of the liver and that of bile in the human economy; it will be sufficient to say that the increased action of the liver is the spring which stimulates all the other glands to greater activity. And, I think, all will agree that this object is of as much importance in tuberculosis as in any other disease.

Another great advantage of these exercises in help-paired in tuberculosis. The direct consequence of the less cases is the prevention of suffocation and the dreadful agony under which consumptives die sometimes. I have lost but one case which ended in this way; the exercises seemed to have no effect whatever; there seemed to be a complete paralysis of the nerves and muscles; autopsy was not permitted. All the other lost ones perished of tubercular diarrhoea and exhaustion, showing an easy and almost imperceptible death.

Having regulated the thoracic exercises to the best of our judgment, we proceed to regulate the digestion. It will be found that all consumptive patients crave peculiar articles, especially pickles, acids, and the like. These different tastes are of the greatest importance. If a patient has an excess of fibrin he invariably desires acids; if he is albuminous, he will crave salt. Many complain of a bitter taste in the morning, others of a saline taste, others again of a taste described as similar to rotten eggs, while others have no peculiar taste of any kind. In their preference of food they likewise vary greatly. Many show a preference for meat, others for farinaceous and saccharine materials; they almost invariably dislike eggs, and crave fruit, or something refreshing, as they generally call it. Their digestion is likewise different; some digest meat without any difficulty, but experience oppression after eating farinaceous food; in others again, it is just the contrary. The state of their bowels mostly shows a tendency to costiveness; it is a bad sign if it is the other way. I have found that the more a patient is inclined to costiveness the easier is it to regulate his digestion. From the appearance and color of the fæces we can with certainty calculate upon the state of the digestive glands. The urine generally exhibits acidity and an excess of uric acid. In this case the quantity of the urine is generally below the average, and it has a high yellow

When I first endeavored to obtain this end I met with difficulties in reaching my point, although I tried all the means which are best recommended by experience. It then occurred to me that it would be well in some way to imitate the natural secretions, as near as. possible, and following out this idea I had the satisfaction of seeing my efforts crowned with success. I state this rather for the purpose of showing how I came to use the after-mentioned preparations, than to maintain the theoretical correctness of their application; but this mode of practice never failed except it was owing to organical changes, or a mistake in the diagnosis. Whether the extracts hereafter mentioned are effective by taking the office of bile for the time, or by their chemical composition, or by both together, is a point upon which I shall not speak here. Neither do I intend to decide whether citric acid acts by disengaging oxygen, or by acting as a means for the absorption of more oxygen, or solely by its contracting and acid quality, or by all three together. May it suffice to state that their employment secures our purpose.

As soon as taste and febrile symptoms indicate fibrinosis, I order the pure juice of from one to twenty lemons, as the case may be, to be taken without water. Patients occasionally experience some oppression the first time, which disappears afterwards. As soon as they begin to digest the lemon-juice, the pulse sinks,