ceived in battle, as to the difference in the ratio of recovery of those wounded early in the day, when they are fresh, and those wounded later. Such data would apply to cases of puerperal women; whether the women are fresh from a short labor, or exhausted by a long and tedious one. With our present knowledge of the subject, it matters little, as far as treatment is concerned. whether the poison be chemical or animal. To meet the difficulty of personal infection, we should be careful not to carry the poison about in our daily rounds. Most of the germ destroyers are acids, as carbolic, sulphurous, and salicylic acids, but, as a disinfectant, I would call attention to one which can be found in every household, and that is common vinegar; I have, on many occasions, found it extremely efficacious. After extraordinary exposure, the clothing should be fumigated with sulphurous acid.

Dr. LUSK, in reply, said:-I beg to thank the Section for the attention which has been given to my paper, and for the discussion which has followed. In reply to Dr. Yeomans, I would say that it is true that the presence of lactic acid in the blood causes endocarditis, but that I confined my remarks to a single form of endocarditis, of which the great characteristic is the presence of masses of bacteria upon the cardiac valves. But the great question is, whether the poison can be destroyed after its inoculation has taken place. I think that it can. I think that the mother ought to be separated, in these cases, from the child, as it is better for both. I use Labarraque's solution to disinfect my hands, and have never carried the disease from hospital to private patients.

ON ELECTROLYSIS, WITH SPECIAL REFERENCE TO THE TREATMENT OF OVARIAN CYSTS.

BY

FREDERICK SEMELEDER, M.D.,

OF VIENNA.

ELECTRICITY, the essential nature of which we are unable to explain, reveals itself to us under all the different known forms of motion, both as mechanical power and as molecular movement, whether as light, heat, or chemical action. The phenomena of these are essentially identical; they are correlative, and are constantly being transformed one into another. We can command, to a certain extent, by choosing among the various sources of electricity, and by different arrangements of apparatus, the particular manifestation which we wish to produce; but no form of electricity can be generated which does not display, more or less, all its various qualities. Especially is it impossible to conceive of any electric current acting on a living body without causing chemical action, and perhaps the only way in which electricity can act in the living tissues is through its chemical effects.

Electrolysis is the name given to that application of electricity in which chemical action is principally sought for, and, especially in medicine, when, by the use of either the galvanic or the faradaic current, an attempt is made to dissolve or destroy organic productions, infiltrations, exudations, or distinct tumors. Electrolysis is extensively used for industrial purposes (electrotyping, etectroplating, etc.), but its applications to medicine and surgery are as yet very limited; this branch of electro-therapeutics is still in its infancy, its philosophy is very imperfectly understood, the number of cases in which it has been employed is small, and the data for judging of its value are widely scattered; the time for writing a treatise on medical electro-chemistry has not yet arrived. The effects of electrical currents on simple, inorganic solutions are easily understood; but it is different when we have to deal with organic and highly complex substances, such as are met with in the living body. An electric current passing through common water decomposes it, setting free oxygen at the positive and hydrogen at the negative pole; with a solution of common salt a similar process goes on, the oxygen formed at the positive pole acting on the salt and decomposing it. In the case of liquids like those found in the living body, containing albumen and azotic combinations, we know, as a general rule, that, at the positive (oxygen) pole, albumen, fibrin, fat-acids, etc., are separated, while at the negative (hydrogen) pole there appear the alkaline and earthy bases, iron, and coloring matters.

If an electric current is passed through a watery solution of albumen, in a short time (say five minutes) a clot will be found at each pole; that at the positive pole is the larger and denser, the wire (copper) becomes green by oxidation, and the whole clot has a slight, greenish tinge; the clot at the negative pole is more cloudy, soft, and diffuse, and of a grayish tinge, while the wire becomes blackened from the development of

sulphuretted hydrogen. The same thing is observed (except that the clots are smaller) when the wires are applied, after the shell is removed, to the soft membrane which covers the white of an egg. The above remarks apply to the constant, galvanic current; although the faradaic current also decomposes water and coagulated albumen, yet the electrolytic properties of any faradaic current, which a living subject can endure, are so insignificant, that its value in this respect may be disregarded.

What has been described as taking place in an albuminous solution, is precisely analogous to that which occurs in the living body, the effects varying somewhat, however, according as both poles are introduced or applied on the surface, or as one or the other is introduced while the other is applied externally; and from a knowledge of these differences may be derived varied indications for the therapeutic use of electricity. With these introductory remarks, I beg to call the attention of the Section to a new application of electricity in surgery; I mean the electrolytic treatment of ovarian cysts. When, a year ago, I published my first successful cases, a claim of priority was made by two gentlemen, one of whom had indeed reported cures of ovarian cysts, by electricity, as long ago as 1859. But these cases excited no attention at the time, and were so entirely forgotten that in Prof. Schroeder's Essay on Gynecology, in Ziemssen's Cyclopædia, no earlier cases were referred to than those of Dr. Fieber, published in 1874. All that I claim is the credit of having again brought the method before the profession, and I sincerely hope that it will not require fifty years to elapse before the value of this mode of treatment is acknowledged, as was the case with ovariotomy, the great invention of Dr. McDowell, from whose deserved reputation I would certainly be the last to detract.

But science is constantly progressive, and what was yesterday considered a great triumph, may to-morrow be superseded, and just as legitimately abandoned as it was praised the day before. Hence I do not hesitate to repeat, before this assembly, my assertion, that I hope within a short time to see ovariotomy abandoned, or at least restricted to a very few exceptional cases. My grounds for entertaining this opinion I have recently published at length, and shall not therefore repeat at this time what I have already written; but I will merely say that six cases of ovarian dropsy, which I have treated in this way, have been completely cured in from four weeks' to five months' time, according to the size of the tumor; and that in a case of fibro-cystoma of the womb, under electrical treatment, the liquid contents of the cysts have been absorbed, the fibrous, solid masses remaining nearly unaltered. The ovarian cases were not selected but were taken indiscriminately; the cysts varied in size from that of a cocoanut to that of a pregnant uterus at full term. In one case the tumor was undoubtedly monocystic, with thickish contents; and in another polycystic; in two cases the cyst contents were quite thin; while one was probably a case of dermoid cyst. The ages of the patients varied from eighteen to forty-five years; one was a virgin; one married, but sterile; and four had borne children.

The constant current was employed in all the cases; in one, no needles were introduced, but both electrodes applied to the surface, and yet the contents of the tumor were absorbed. The currents employed were mild ones; no imflammation of importance occurred, and consequently no adhesions were formed; the pain was insignificant, anaesthetics never having been required, and no patient having been confined to bed. "hus far, no relapse has occurred. The method is equally applicable to

single and to multiple cysts; to those with albuminous, with saline, and with fatty contents; to those with and those without adhesions; to those which have and those which have not been previously tapped.

In one of my cases, after the liquid contents had been absorbed, hard, cartilaginous bodies in the cyst remained, apparently unaltered; the cyst walls, in all, underwent contraction, and a solid lump, of the size of a small apple, remained when all the liquid had disappeared. One obvious advantage of this method of treatment over ovariotomy, is that it does not deprive the patient of one of her most important organs. The sittings, in my cases, usually lasted only a few minutes, and were repeated daily-in one case, even during the menstrual period.

The modus operandi of this method of treatment is not thoroughly understood. In addition to the decomposition and absorption of the liquid, some change must take place even in those parts of the cyst walls which do not come into direct contact with the electrodes, for the further production of liquid is prevented. Dr. Althaus's theory as to the effect of electricity on tumors containing saline liquids, is that, the salt being decomposed, a caustic alkali is formed, and by setting up a mild inflammatory process increases the vitality of the tissues, and thus leads to the absorption of the fluid.

Before resorting to ovariotomy in any case, the surgeon should at least give electricity a trial; for, even if it fail, the patient will be in no worse condition for the operation, while the risks of the latter more than counter-balance the evil of a little delay.

PARACENTESIS, ASPIRATION, AND TRANSFUSION.

BY

SIMON FITCH, A.M., M.D. EDIN.,

OF ST JOHN, NEW BRUNSWICK, CANADA.

FIFTY years ago, paracentesis was seldom employed, except in cases of fluid distension of the abdomen, bladder, or scrotum, after other means of relief had failed, and then it was a clumsy and unvalued procedure. The old trocar, having a triangular point and a big head, with a split canula behind it, went in with a jerk, endangering intestine and testicle in tapping for ascites and hydrocele; then the canula, pushed onwards over the big head expanding the segments of its split end, would often catch some bit of the three-cornered aperture, and fail to enter perfectly, or in entering would tear or split up the edges of the aperture, and allow the fluids to leak injuriously into or upon the neighboring tissues, as in the operation for hydrocele, or in puncturing the bladder; and finally, the instrument would leave a jagged, punctured wound, indisposed to heal.

But at the present time paracentesis is called upon both to detect and treat a marvellous variety of diseases, and some of them of great importance, such as hydrothorax, empyema, hydro-pericardium, ascites and purulent deposits in the abdomen, cysts of the broad ligament and of the ovary, intra-pelvic and lumbar abscesses, retention of urine with impermeable urethra, distressing tympanitis, strangulated hernia, hydatids and abscesses of the liver and kidneys, hurtful effusions within or about the hips and other joints, hydrocephalus, and spina-bifida; and the present duties of paracentesis are more critical, in consequence of the sensitive and vital character of the textures and parts in and upon which many of these diseases are situated, such as the lungs, the heart, the abdominal viscera, the pelvic organs, the great joints, the spinal cord, and the brain.

In dealing with such diseases, in such parts, none of the trocars now in use are equal to what is required of them, either for exploration or for

treatment.

Paracentesis now, with or without aspiration, with or without injection, is commonly done either with a single tubular trocar having an unguarded point (which is most dangerous to the interior), or the guard is an open canula, to be pushed over the point after it has entered, and of itself only somewhat less dangerous if it gets in, while it is uncertain to enter; and we will do wrong to employ these uncertain and dangerous instruments if an efficient and safe instrument can be had.

The perfect trocar should be: (1) Easy of insertion, the puncturing tube entering by a clean incision, and the protecting canula following without the least stretching of the aperture, or possibility of failure; (2) Harmless when inserted, so that it shall not injure the interior of the cavity, or adjacent parts; (3) Safe as a probe or sound, or artificial finger, for internal exploration; (4) Adapted to the aspirator and every form of exhausting apparatus, both attachment and detachment being instantaneous; (5) Competent to give the freest exit or entrance to fluids to be dis