tance to them. We can but respect the feeling which revolts at thoughts of the mutilation of bodies recently tenanted by the loved and lost; and when performing this duty which we owe to the living, we should always remember that we are in the house of mourning. Yet when we can assure the friends, as we truly can, that the form and features will appear as before; that while we search in that precious dust, which soon will mingle with its mother earth, for that invaluable information which, while it gives us the true morbific biography of the departed, may enable us to save from suffering, perhaps from death, some other most near and dear ones; and that about all we know of diagnosis and prognosis has been learned in this way,—it would seem that opposition ought to be removed. We find indeed this is quite often the case, the readiness of compliance being as a rule the measure of intelligence.

As physicians add to their knowledge of morbid processes, their appreciation and usefulness will be increased. To us, as homœopaths, will the practice we advocate be of special advantage, as the opinion is entertained that we simply prescribe for prominent symptoms, and ignore their cause. A systematic search for the cause of the manifestations we witness, in the manner indicated, will disabuse the community of this error. But it was not my only or principal purpose to-night to urge upon my fellows its importance to them, or to the public, in an educational aspect, momentous as it is.

There always have been unprincipled persons who pretend a knowledge of medical subjects they do not possess, and by exciting the fears of the mentally weak and of the ignorant, or by promising impossible cures, sponge the last dollar from the incurable and his friends, thus depriving him of comforts and little delicacies so grateful to the failing appetite; or worse still, by their blundering treatment, render cases which with proper care would recover, irremediable, dooming the subject to a life of suffering, perhaps mercifully a short one.

From a very remote period society has been trying to rid itself of these cormorants, as well as to protect itself against heedless, reckless, and incompetent practitioners. But the laws that have been made have been seldom enforced. If in some isolated cases attempts have been made to do so, the testimony of medical men being necessary to convict, the charge that they are simply acting as did the ancient Ephesians has generally been sufficient to cause a disagreement of the jury, so that the law has little

terror.

Again, the test of admission to the profession, though entirely proper, affords no security against recklessness, heedlessness, or mental deterioration. To save us from all these dangers, we

should have a criterion which has the efficiency of a law that executes itself. It seems to me such a measure is not far to seek, or difficult to apply, if it can be sustained by public opinion. The principal object of writing this paper is to contribute toward building up a sentiment which shall require that to the work of the physician shall be applied the same rules which hold good in all other branches of human endeavor. The framer of every legal document knows that it is liable to be examined and its merits passed upon by men learned in the law, or experts in business. So the success of the artist, the architect, and the artisan depends upon the opinion formed of their productions by persons conversant with their several requirements. Of the practitioners of medicine alone has it been truly said that while their successes walk the streets, their blunders are covered in the grave.

We believe the time is coming when it will be conceded that the physician has a right to justify his conduct of a case. It is allowed the commander of a boat, of a military company, or any one to whom is intrusted the life of another. It can be done in this way without any legal process. As promotive of it we would suggest that there shall be in no case any charge for a post mortem examination, by any physician who attends a case, whether requested by himself or the friends, unless the result is likely to involve legal inquiry.

Let it be distinctly understood that we ask no legislative enactment. We would even be decidedly opposed to any, believing it would be regarded an unwarrantable interference with private rights and feelings, which on this subject have an almost sacred character, and would so excite opposition as to retard rather than advance the much-needed reform. We would rather, as before intimated, accomplish our purpose by impressing people with the great advantages to be derived from the general adoption of such examinations (to some of which we have alluded); confident that when it becomes the usual practice, at a time not far distant, skilful though modest diagnosis will be accepted before simple, positive assertion.

LACERATION OF THE PERINEUM.

BY JOHN J. SHAW, M. D., PLYMOUTH, MASS.

THERE Seems to be good deal said in the different medical journals in regard to the above subject. My practice has of course been very limited in comparison with that of many others, but still it may not be altogether a matter of chance that I have had but one case of this accident, and that occurred

before my arrival. My method is neither original nor new, but perhaps some may derive benefit from having it called to their attention.

I always use lard freely, especially with primiparæ. Before the head begins to press on the perineum, I begin to apply the lard, and with steady, gradually applied, and quite forcible pressure, I anticipate nature, so that by the time the head has been brought down upon that organ, it has become dilated to a considerable degree.

Between the pains I now continue to apply the dilating force, and the lard. As soon as the perineum is put upon the stretch, and the occiput is beginning to pass over the pubic arch, I pass two fingers of the left hand into the rectum, and by forward pressure assist, with some degree of force, the passage of the occiput over the pubes; while at the same time, with the thumb of the same hand, I endeavor to draw back the perineum, assisting it at length to slip over the sinciput, by placing the fingers of the right hand on one side, the thumb on the other, and pressing it backward.

The correctness of this procedure is proved by the fact that the force applied by nature for the expulsion of the head is in many cases, where the perineum is wide, applied almost directly down upon it, and, especially if the parts are rather dry, there is great danger that it may not slip back in time to be saved from laceration. When the shoulders are coming down, let nature do the expelling, but manipulate them so as to relieve the perineum as much as possible.

Finally, I believe it is as contrary to good sense to deliver the placenta by drawing it out, as it would be to draw out the child in a natural labor. It is a natural irrit and excitant of contractions, and the chances of excessive flowing will be much diminished if it is allowed to remain until it has produced its normal effect. If after a proper length of time and proper excitation, the uterus refuses to expel it, of course it must be taken. Let it be borne in mind, however, that these remarks apply to its removal from the uterus, and not from the vagina. No good end is gained by leaving it in the vagina after the uterus has expelled it.

WHERE TO LOOK.

BY H. W. TAYLOR, M. D., CRAWFORDSVILLE, IND.

WHILE etiologists and sanitary scientists are vainly interrogating earth, air, and sky for signs of approaching epidemics, and while the literature of sewage and ventilation has become a wild ex

travaganza in the music of the spheres, the only solid ground that has already had such preliminary survey as to give assurance that it is solid ground for the etiologist, remains, save as to its border land, a vast terra incognita.

Nor is it because of impassable barriers of icy mystery rising like frowning walls upon the border of this true ground of the etiologist, that no hardy explorer has hitherto penetrated its dark forests and tangled thickets. On the contrary, it is perhaps so easy of access as to be held in contempt by that etiologist who yet bends under the burden of the accumulated opinions and theories of thirty centuries, and who is thus impressed with the vastness of that problem that apparently defied solution from the dawn of animal life down to this present midday of existence.

I say "apparently escaped solution," because it is not certain that the ancients did not have more than an inkling of the truth. Thus the animal origin of the disease of animals is shadowed forth in the Archæus, that was himself a living creature. Again it was brightly prefigured in the Greek legend of Pandora, who opened a casket and let loose the thousand swift-winged evils and ills of mortal flesh, holding back only delusive hope.

Thus it is fairly inferable that the ancients attributed the various diseases to actual living animal agencies. The winged evils of Pandora are the swift-winged and sure-footed legion of beasts, birds, reptiles, and insects that to-day contest with man for sole possession of that great battle-field, the earth.

All disease is the effect of an animal poison which is made to mingle with the tissues of other animals, producing identical or similar diseases in the inoculated animal. The modes of inoculation are various. Sometimes it is directly through the broken skin of the hand, as in the communication of erysipelas from a patient to his careless medical attendant. More frequently the inoculation takes place in the pharyngeal follicles, in which are lodged and held minute particles of epithelial débris exhaled in the moist breath of the sick, and inhaled into the throat of the well when in near proximity. But in the vast majority of instances of inoculation of animal virus, such inoculation takes place in the act of deglutition of food and drink. The peculiar structure of the pharynx, with its fringed rugæ of follicular glands, renders it impossible that any solid can pass into the œsophagus without paying small tribute to the grasping walls of the pharynx. A careful inspection of the pharynx after meals will demonstrate this physiological and etiological fact. In this manner we probably contract pleuro-pneumonia from the freshly killed and half-cooked flesh of hogs. The swine is subject to an eruptive disease, closely resembling scarlatina in man; and it is not improbable that all the winter epidemics to which all civil

ized countries are subject are derived from the animal flesh that is used in its recent state for food only at this period.

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Tuberculosis is that glandular inflammatory process that is set up in the Quadrumana from any suppurating wound. Numerous observations discover the fact that the inflammatory process in the Quadrumana results in inflammation of lymphatic glandular structures. Lymphatic glands are by far the most numerous in the lungs. Hence it is the lung tissue that chiefly suffers in these glandular inflammations, which, going on to enlargement and cheesy degeneration, form cavities in the structure and produce consumption." Is it not reasonable that this chief disease of the Quadrumana can and must be inoculated in the pharynx of the creature that eats the flesh and blood of the diseased animal, which has been so recently slaughtered that the hydrogen of the air has not yet had time to annihilate the poison which we know is therein contained? The production of tuberculosis by inoculation with the blood of the tuberculosis subject is demonstrated. Involuntary inoculation takes place with the greatest facility in the pharyngeal follicles. Did Moses have these facts in view when he said, "Ye shall eat the blood of no manner of flesh," and "Whosoever eateth it shall be cut off"?

In the water which we drink must be large quantities of "flesh and blood" in the aggregate. But we are on the wrong road when searching for infusoria with the microscope, or for albumen compounds and gases with the test-tubes of the chemist. The great entomological order of Diptera furnishes us with the poison that makes Intermittent Fever, Typho-Malarial Fever, Typhoid Fever, and Yellow Fever; to the Culex Americanus we may safely credit all the various phases of Intermittent Fever; while to the Musca Domestica belongs the honor of the production of that terrible pandemic, Typhoid Fever, and its congener, Typhus.

Here, then, is the true field of the coming etiologist, a field untrodden in modern times; a field fallow since the days of Moses; a field into which Hahnemann, with his all-inquiring mind, was about to set venturesome foot, when he declared that domestic animals were carriers of disease; a field in which some laggard explorers like me have caught dim glimpses of the astounding and terrifying spectacle of the dispensation of poetic justice, in the wreaking of vengeance upon the all-powerful animal man, by the puny tribes of the Quadrumana and Diptera.

CREMATION. According to the "Medical Record," a memorial in favor of cremation, signed by over one hundred members of the British Medical Association, has been presented to the Home Secretary. The memorialists state that they disapprove of the present method of burying the dead, and pray that the government will not oppose the practice of cremation when it is done under proper restrictions.