abdominal walls a short distance inside the deep ring; and to tie off the sac higher and more evenly than by any other plan. An autopsy in a case that died from causes foreign to this subject, sometime after being subjected to this operation, should, according to Dr. Abbe, who was present, be a perfectly smooth peritoneum opposite the deep ring, marked by a punctate cicatrix only.

Prior to ligation-which is done with either stout silk or catgutthe sac is opened for examination of its contents; and during ligation it is held vertically while the index-finger of an assistant is kept deeply in its neck to prevent a nipping of the gut or omentum. The ligature is tightened over the tip of his finger, and flush with the general peritoneum, after which the sac is cut away as close to the ligature as safety will permit.

Dr. McBurney believes that a firm, deep and solid cicatrix will offer the greatest resistance to the return of the gut; and, judging by analogy, there is no reason why it should not be permanent when once formed. He makes the two walls of his wound as nearly solid and homogeneous as possible by from four to eight stout catgut or silk stitches placed on each side. These should invert the skin and go through all the abdominal layers down to the transversolis fascia, on their own side of the wound. Now, the wound must heal from the bottom. But it is too wide, and therefore two or more heavy sutures are placed across it, drawing the edges so that the average width of the space between the lips of the wound shall be from one-fifth to one-fourth of an inch. These last sutures pass down to, but not through, the abdominal muscles, and are tied over pledgets of iodoform gauze, in order to prevent their cutting. The wound is now irrigated, dusted with iodoform and packed firmly with iodoform gauze to the very bottom. This firm packing prevents an oedema, which otherwise occurs, and interferes with granulation. The scrotal or labial wound is sewn without packing, and may be drained from below if thought advisable.

An ample bichloride gauze dressing is applied and bound securely in place. A large square of rubber tissue, having a hole for the penis in its center, is put in place just beneath the bandage. In women, especially, it is well to catheterize for some days to avoid risk of soiling the wound. In children, for the same reason, a shellac-coated plaster-of-Paris dressing is advisable. The dressing is changed and renewed as before, at the end of five or six days.

The average time required for complete healing is from five to six weeks; at the end of which time the patient will have a very strong cicatrix; hence the delay for this length of time in bed is advantageous, enabling the subject to discard the truss altogether. In fact, Dr. McBurney strongly disapproves of the truss, believing that its constant pressure tends to cause weakness of the scar.

The cut below is from a photograph taken from the patient after recovery.

HYDRASTININE in uterine hæmorrhage is a new remedy mentioned in the Therapeutic Gazette. Dr. Falk reports that out of 26 patients treated, 4 were not either improved or cured. Hydrastinine is obtained from hydrastin by gently warming it, diluting with nitric acid, the product precipitated with an alkali, the new base hydrastinine is the result.

CURRENT NOTES.

TRICHNIÆ are not actively affected by freezing.

PROF. GEO. H. ROHE, M.D., has been appointed Health Commissioner of Baltimore. Good!

WE are sorry to learn from the Sanitary News that Dr. Rauch has retired from the Illinois Board of Health.

ANTIFEBRIN (Acetanilid) is soluble in concentrated lactic acid, and soluble in weak lactic acid at the boiling point, recrystallizing on cooling.

A PORTRAIT and sketch of the late DR. W. P. MALLETT, of Chapel Hill, appears in Vol. IX., No. 2 of the University Magazine, published at Chapel Hill. It is a commendable spirit in that Journal to rescue our worthy dead from the neglect usually shown.

BI-CHLORIDE OF MERCURY IN INFANTILE DIARRHEA, by Ringer, and the biniodide of mercury treatment, by Luff, must have some merit. It is given as an antiferment. The biniodide is given in 1-50th grain doses with one grain of chloral hydrate.

POST-PARTUM HÆMORRHAGE, Iodoform Gauze in.-O. Piering, M.D., in Lancet.-I recommend that, when post-partum hæmorrhage comes on, the bladder should be emptied, and-forcible friction, intra-uterine irrigation with hot or cold water, and hypodermatics of ergotin employed; if the hæmorrhage still continues, the cavity of the uterus should be filled with iodoform gauze, the irritation produced by this setting up active and permanent contraction. The method has the advantages of great certainty, complete harmlessness and facility in its performance. In several recent cases it was employed with complete success. In no case was harm done by it. Resort to the plug should not be too long delayed.-Archi. Paediatrics.

THE Conclusions of Hyderabad Chloroform Commission contain nothing new, merely emphasizing facts which have developed in the practice of chloroform anesthesia. We note, though, that while morphine is considered advantageous injected at the beginning of the administration of the drug, that "atropine has not been shown to do any good, and it may do a great deal of harm."

MALARIAL FEVER, Influence of on the Puerperium.-Transcaucasian Lying-in Hospital Reports.-With regard to the influence of malarial fever on the puerperium, Dr. V. E. Krusenstern, of Tiflis, has recently published a paper. His views may be summarized as follows: Malarial fever generally, and in its remittent form in particular, does not retard the post-partum involution of the uterus. He states that in cases where women have suffered from malarial fever, the uterus has decreased in size as in normal cases. He thinks that the sub-involution in malarial puerpera women, which has been described by many authors, is due to an intercurrent endometritis complicating the fever, and not to the malarial poison itself. He goes on to state, however, that the malarial poison, if attacking a puerperal woman, affects the mammary secretion, diminishing it most markedly.-Archiv. Podiatrics.

SCARLET FEVER.-J. C. Wilson, M.D., in The Dixie Doctor.— 1. The treatment of scarlet fever by chloral hydrate, without the use of other drugs, has yielded most satisfactory results. 2. The chief roll of chloral in the treatment of scarlet fever is that of a

sedative to the cerebral centers. It appears to antagonize certain exciting toxic principles formed within the organism during the course of the disease. 3. Chloral is also useful on account of its antiseptic properties, (a) upon the throat; (b) upon the kidneys; (c) to a slight extent upon the fluids of the organism at large. It is necessary in this connection to bear in mind the difference between the germicide and the antiseptic influences of drugs. No amount of chloral compatible with the maintenance of life can act within the organism as a germicide. It is assumed that medicinal doses may tend to render the fluids of the body antiseptic-that is to say, may tend to impair, to some extent, their fitness as culture media for pathogenic bacteria. 4. The elimination of chloral by the kidneys and its diuretic effect render it especially useful in the treat

ment of scarlet fever. [We have used this method of treatment, and can indorse it as doing all that is claimed and more. Patients do not, as a rule, complain of the taste when it is given as follows:

M. ft. sol, Sig.-Teaspoonful in a little cold water every 3, 4 or 5 hours for an adult. Double the quantity at bedtime.

A gargle containing chloral, or mopping the throat with a chloral solution, or a solution of biniodide of mercury, one to five hundred, will control the throat symptoms equally as well as the spray. The mop is much more easily used, especially with children, than the atomizer.-ED.-Archives Podiatrics.

CONCENTRATED ENEMATA OF EPSOM SALTS.-Some years ago Dr. Matthew Hay made a series of experiments upon the use of concentrated solutions of magnesium sulphate given by the mouth. He found that they rapidly drew water from the blood into the intestines. Thus, the bowels having been well emptied, he gave three-quarters of an ounce of the salt, and in half an hour (the time of greatest concentration) obtained an increase from 5,000,000 to 6,790,000 blood-corpuscles; that is, of 1,790,000 to the cubic millimetre. This increase was not obtained if the alimentary canal was not emptied, or if a diluted solution was used. He attributed the concentration to the action of the salt in depriving the tissues of water. The experiments of Moreau and Lauder Brunton have also shown that magnesium sulphate has the power of producing copious exudation into the intestines, and that its cathartic action results from this and not from any direct stimulus to peristalsis. Acting upon these observed facts, Dr. T. J. Watkins, of Chicago (Maryland Medical Journal), began the use of concentrated solutions of magnesium sulphate in the form of enemata. He employed at first a mixture of two ounces of the sulphate and four ounces of water. For more than a year this solution was used by Dr. Watkins at the Woman's Hospital of the city, and with excellent results. He finds it inuicated not only in constipation, but in serious intestinal obstruction when there is much nausea and vomiting; and after laparotomy, when sepsis and peritonitis threaten to