the growth and general intoxication of the subject would follow. With ordinary caution, however, he was able to avoid these untoward effects by injecting 10 to 20 minims into one side of the tumor, then as much in another place, etc., this being continued until every part of the growth had become infiltrated by the alcohol.

An extremely interesting case has recently been reported, which not only adds considerable evidence to that already adduced, but also furnishes an opportunity for a profitable study of the whole question by deductive reasoning. The case was one of scirrhus of the breast treated by William Yeats.* The patient was a widow, aged 58 years, whose left breast was already twice as large as the right and ulcerated at the nipple. On February 20th, of a mixture of 40 parts of absolute alcohol and 60 parts of distilled water, 23 syringefuls, each of 20 minims, were injected deeply into the tissues round the tumor, and into the axilla in the neighborhood of the enlarged glands. The injections, averaging from 22 to 25 syringefuls each time, were repeated about every fifth day until May 2d. Each sitting occupied about three-fourths of an hour. The injected fluid had a great tendency to flow out again, but the author found that this could be obviated by smearing collodion over the needle-pricks. The patient experienced considerable pain, lasting from one-half to one hour. After the second series of injections she declared that the sensations in the breast were altered, the shooting pains were no longer felt, while the itch ing on the surface of the mamma, which she had complained of, disappeared and never recurred. After the subsidence of the immediate painful effects of all the other injections, the patient felt more comfortable in every way. When the process had been continued for five weeks, the parts round the tumor began to be edematous, but still the injections were continued into and beyond the edematous parts. During the sixth week the patient and her nurse stated that they considered that the growth was smaller, and certainly at the beginning

* British Medical Journal, Sept. 25, '97.

of the eighth week (April 11th) the whole breast, including the tumor, had diminished in size.

After this date, a'l the parts, breast and tumor, rapidly shrunk, until in May there was actually nothing left of the mamma to be felt by the hand, and practically nothing left of the tumor, but the nipple and slight thickening under it. There was still edema in the injected area. The glands in the axilla could not be detected. At this time Mr. Windsor examined the case (May 12th) and stated "that whilst the right was a fairly large hanging breast, the other-the left breast

had practically disappeared, the nipple only remaining; that he did not find any thickening under the pectoralis nor enlarged glands in the axilla." After these seventeen injections, a complete structural change to all appearance having taken place, it was intended to continue the injections at longer intervals for a considerable time, but, unfortunately, the patient became ill otherwise. She lost her appetite, became slightly jaundiced, and on examining her on May 16th it was found she was suffering from cancer of the liver with ascites. This being the case, nothing further was done; the patient rapidly grew worse, and died on June 10th.

At the autopsy the mamma was found replaced by a dense, fibrous-looking mass with several processes extending into the surrounding fat and firmly connected with the subjacent pectoral muscles. The skin was rough, superficially ulcerated at one place, and adherent to the subjacent tissue round the nipple. The nipple was depressed, but not considerably retracted.

*

Going a step farther, we are brought to a case reported by Edwin J. Kuh,* of Chicago, the diagnosis of which was confirmed clinically by Senn, and furthermore by a microscopical examination which allows of no reasonable doubt. The case was one of primary cancer of the naso-pharynx in which the injection of unfiltered erysipelas-prodigiosus toxins had failed. In view of the inevitable fatal outcome, injections of alcohol were begun on October 14, 1896,

* Medical Record, April 17, '97.

with 3 minims of absolute alcohol, the dose being rapidly increased to 30 minims. The reduction in the size began after the seventh injection, and after the eleventh but few remnants of the growth remained. After a dozen After a dozen more injections the needle would not penetrate into the tissues capable of retaining the alcohol, and after a few additational attempts, at intervals of a week or longer, they were discontinued. In February, 1897, the naso-pharynx was found, both by inspection and palpation, to be entirely free.

This case, added to the others described, establishes alcohol on a basis seldom equaled by any agent proposed. In order to obtain a successful result, however, the treatment must be carefully

conducted.

In the cases reported as cured by him, Hasse injected a mixture of 30 parts of absolute alcohol to 70 parts of water twice a week around the tumor, as well as into any infiltrated glands. The quantity injected varied according to the size of the neoplasm and sometimes reached 20 Pravaz syringefuls. The only inconvenience observed was pain and occasionally slight intoxication. In order to avoid making the injection into a bloodvessel Hasse inserted the syringe-needle deep into the tissues, then unfastened it, leaving the cannula in place.

He

then waited a moment; if the blood did not issue from the cannula he readapted the syringe and made the injection; but, if blood did flow out, he removed the needle and made another puncture elsewhere. Under the influence of these injections the tumor diminished in size and soon became less painful. The treatment should be continued for some time after apparent cure, at intervals more and more prolonged.

Pain seems to be the only untoward effect of the procedure. Local hypodermic injections of water are known to cause anæsthesia. This or some other local anesthetics might be employed to obviate the only feature that might cause the sufferer to refuse assistance. General anesthesia might even be resorted to for the first injections in sufficiently robust subjects until the treatment has itself reduced local tenderness.

The remarkable increase of cancer

during the last half century need hardly be emphasized. The nature of the affection sufficiently sustains an earnest plea that alcohol be given the faithful trial it seems to merit. Editorial in the Monthly Cyclopedia of Practical Medicine by Dr. C. E. Sajous.

Aged Parents.

A woman in Toronto who is over sixty years of age gave birth on January 21st to a baby girl. Her husband, to whom she was married seven years ago, is seventy-eight years of age. The mother has been married twice, and this is her twenty-second child. The day after this, not be outdone by any foreigner, a woman sixty-five years old, living in Oklahoma, also gave birth to a baby girl. This mother has also a number of other children, ranging in age from thirty-five to forty five years. Some of the male sex have, as might naturally be supposed, better records than this. A Tyrolese gentleman named Parravicini, is reported to have married at the age of eighty-two years, and to have been the father of seven children, the last of whom was posthumous, his father having died at the age of one hundred and four years. Juba, king of Mauritania, is believed to have died at the age of ninety-one years, leaving a posthumous child.-N. Y. Med. Record.

The Indications and Contraindications for Bicycle-riding in Women.

Fauquez's conclusions in the Journal des Connaissances Medicales for August 26th, may be summed up as follows (Gynécologie, December 15th): Bicycleriding may be recommended in cases in which there is absolute integrity of the genital organs, for anemic and chloroanemic persons, for dyspeptics; for bicycle-riding may be permitted in cases of mechanical dysmenorrhea due to an obstruction to the discharge of blood, either congenital or acquired, and in membraneous dysmenorrhea; in cases in which the uterus becomes displaced; in cases of chronic metritis connected with the arrest of involution of the uterus after confinement or abortion, if it is not painful and recovery has begun. In this case, however, the exercise must be taken in moderation; in cases of leucorrhea in anemic and chloro-anemic

persons, and in cases in which the general condition is weak.

Bicycle-riding must be absolutely proscribed as follows: 1. In amenorrhea connected with pulmonary phthisis, cancerous affections, diabetes, organic diseases of the heart and diseases of the kidneys, such as albuminuria. 2. In cases of metrorrhagia or excessive menstruation. 3. In cases of inflammation of the uterus and its annexa, acute metritis, chronic painful metritis, hemorrhagic endometritis, purulent endometritis, leucorrhea connected with an inflammatory condition of the intra uterine mucous membrane, inflammation of the annexa, salpingitis, oophoritis, salpingo-oophoritis, perimetritis, pelvic cellulitis and pelvic abscesses. 4. In cases of pelvic hematocele and of fibrous. tumors during the hemorrhagic stage. 5. In cases of inflammation of the vulva or vagina before complete recovery.N Y. Med. Journal.

The Treatment of Fractures.

1. Unless a fragment is threatening to break through the skin, the fracture should never be reduced except by a physician, and then only when apparatus is at hand to keep the parts in permanent apposition.

2. Men carrying an injured person should not keep step, as the jar to the wounded part is much greater.

3. Strychnia for shock, morphia for pain, but no alcohol.

4. Always give anesthetics for reduction of a simple fracture. It is better and easier to reduce and set compound fractures without anesthesia.

5. It is very rarely necessary to make a patient go through the double agony of "temporary" and "permanent " setting of the broken bones.

6. In simple fracture gentle rubbing of the ends will assist in getting rid of shreds of tissue which invariably are caught there.

7. Nowadays a surgeon will rarely be satisfied that a bone is properly set, until verified by the X-rays.

8. Plastic splints, preferably plaster of Paris, are surely the best apparatus when they can be applied.

9. Ambulant treatment is coming more into vogue. No simple fractures re

quire constant confinement to bed, except of the innominata and upper third of the femur.

10. It is not necessary and sometimes very harmful to "wait for the swelling to disappear" before putting on a permanent dressing.

11. A well applied splint with good apposition of fragments should not be removed too early. It is not necessary to apply massage early in ordinary cases.

12. Proper time for massage is two or three weeks after fracture of upper extremities and four or five weeks for lower extremities-if the bones are slow to unite firmly.-Med. and Surg. Reporter. Some Practical Points About Heart-Disease.

Don't feel called upon to give digitalis as soon as you hear a murmur over the heart. Study and treat the patient, not the murmur.

Don't conclude that every murmur indicates disease of the heart.

Don't forget that the pulse and general appearance of the patient often tell more than auscultation.

Don't neglect to note the character of the pulse when you feel it. Possibly you may look at the tongue to satisfy the patient; feel the pulse to instruct yourself.

Don't think every systolic murmur at the apex indicates mitral regurgitation; every systolic murmur at the aortic interspace, aortic stenosis. The former may be trivial; the latter may be due to atheroma of the arch of the aorta.

Don't say every sudden death is due to heart disease.

Don't forget that the most serious diseases of the heart may occasion no murmur. A bad muscle is worse than a

leaky valve.

Don't examine the heart thru heavy clothing.

Don't give positive opinions after one examination.-Phila. Med. Journal.

How to Become an Efficient Writer. I know a dentist past middle age, who though a blunderer in English composition, resolved to become an efficient writer. He bought all the books on the subject he could find, and studied the best authors. He made these his almost constant companions for years, and all this time he sought to reduce to practice

what he studied.

I have known him work at a single page of composition for hours, and even then put it aside for future improvement. One of the first essays he read at his State Association cost him over a week's solid work, and yet it was only four foolscap pages long. And during the reading of it he saw so many errors he became too ashamed of it to hand it to the secretary. It seems incredible that this was after more than a year's careful study and practice of English composition. He is now only a tolerable writer, though he has had many years of experience.

We do not give this incident to discourage others, but to encourage the most discouraging blunderer to persevere.-Dental Brief.

The above is a lesson and a suggestion for doctors as well as dentists.

Office Bores,

In the meanwhile the tales of woe must go on. The uprisings and downsittings must be noted by urination at night and defecation in the morning. It is comforting for the innocent professional victim of such constant watchfulness to realize that at such times he is always kept in mind. The urinary bottle with its daily tribute is ever ready to offer its suggestion as to what has been done and still must be done so long as the visits continue. Each receptacle marshals itself in the solemn waiting row of similar odorous companions ruthlessly consigned to dilatory neglect, and the effectual corking of its contents is an implied revenge on the ever-ready fluency of the generous distiller. All such patients mean well, and so does the consultant who naively declares, after emptying the bottle, that "nothing was found" in the specimen.

Then comes the furtive young man, with wavering focal concentration, weak lip and pasty palm, whose manly substance is tapped in the unguarded hour of sleep, and who wakes only to find that all is gone. Even this may be tolerable in comparison with the livelier and more ambitious youth, who voluntarily courts the pang of repentance in his more progressive ventures in the highways and byways of forbidden pleasures. What is lacking in the effusive mucosity of one

is more than made up in the other. The miserly mournfulness of the spermatorrheic is duly offset by the generous prodigality of the gonorrheic. On the principle of easy come and easy go, the virus is scattered in the office of the doctor, on his carpet, chair, paperweight, doorknob and towel, with a zeal that is grimly suggestive of a better cause. The tear of pity, if it ever comes for the oozy sufferer, can never be safely wiped away by the hand that has shaken his.

And lastly, who does not see the young and confiding unmarried female, who has caught cold by temporarily sitting on picnic grass, and who tells the old, old story of a deferred catamenial hope that maketh more than one heart sick?

Or, worse than this, how often does the casual and plausible youth mock the claims of an ordinary credulity when he confidingly asks, on behalf of a dear and absent friend, for the pill that will do the business and end anxiety?

Think of the poor doctor who must be made to believe it all, and sympathizingly play the usual fool besides. Next -come in, please."-Med. Rec.

Progress

The

The way in which members of the regular" (!)-God save the mark! -profession have vilified and abused their "homeopathic" and "eclectic" brethren in the past,and the spirited manner in which these practitioners have repelled the attacks, have had much to do with the fall in public opinion. time is ripe for the burying of sectarianism in medicine. If the progressive, honest, far-seeing members of the American Medical Association will openly and freely pass a resolution which shall allow all affiliating bodies to accept for membership graduates of reputable homeopathic and eclectic schools, who do not use the term "homeopath" or "eclectic" to trade upon, who are simply known as "physicians" and practice as they please (as do we all), and allow consultation with such practitioners, the problem of obliteration will soon solve itself; and one of the chief obstacles to proper medical legislation will have been removed.

Kansas has taken the lead in the mat

ter-as she so often does in matters of reform. This year the "regular," the "homeopathic" and the "eclectic" societies are to meet at the same time and place, and some joint sessions will be held to take united action for the purpose of securing needful medical legislation in that State. What will be accomplished remains to be seen; but it is not at all unlikely that if the American Medical Association were governed by liberal-minded gentlemen, and would permit such action as these three bodies of Kansas, the three National organizations might be amalgamated, with the effect of forming one powerful organization, which could be wielded for the public good, effectually and speedily.

Let every city and county medical society in the country which is in affiliation with the American Medical Association pass this resolution and instruct its delegates to vote for it:

Resolved, That henceforth all local and State medical societies in affiliation with the American Medical Association be permitted to admit to full membership any graduate of a reputable homeopathic or eclectic college who is an honorable man, a conscientious practitioner and who does not use the name "homeopath" or "eclectic" upon his sign or card or in any other manner calculated to secure business upon the assumption that he is practising some peculiar system of medicine. Dr. Emory Lamphear, in Amer. Jour. of Surg. and Gyn.

Surgery Among Birds.

Some interesting observations relating to the surgical treatment of wounds by birds were recently brought before the Physical Society of Geneva by M. Fatio. He quotes the case of a snipe, which he has often observed engaged repairing damages. With its beak and feathers it makes a very creditable dressing, applying plasters to bleeding wounds, and even securing a broken limb by means of a stout ligature. On one occasion he captured a snipe which had on its chest a large dressing composed of down taken from other parts of the body and securely fixed to the wound by the coagulated blood. Twice he had brought home snipe with interwoven feathers strapped on the site of fracture of one of the limbs.

The most interesting example was that of a snipe, both of whose legs he had unfortunately broken by a cruel shot. He recovered the animal only on the day following, and found that the poor bird had contrived to apply dressings and a sort of splint to both limbs. In carrying out this operation some feathers had become entangled around the beak, and not being able to use its claws to get rid of them, it was almost dead from hunger. In a case recorded by M. Magnin, a snipe that was observed to fly away with a broken leg was subsequently found to have forced the fragments into a parallel position, the upper fragments reaching to the knee, and secured them there by means of a strong band of feathers and moss intermingled. The observers were particularly struck by the application of a ligature of a kind of flatleafed grass wound round the limb, of a spiral form and fixed by means of a sort of glue.-Our Dumb Animals. Report of Two Cases of Double Castration for the Relief of Senile Hypertrophy of the Prostate.

By John W. Dillard, M.D., Lynchburg, Va.

CASE I.-Mr. V., age 55 years, from a neighboring town, consulted me two years since for what proved on examination to be tuberculosis of the testes, with senile hypertrophy of the prostate, and all of the very annoying vesical symptoms accompanying this pathological condition.

I advised the immediate removal of both testicles, assuring him that the operation was imperative so far as the diseased testes were concerned, and that by this operation he might escape a supra-pubic cystotomy.

He consented; the operation was performed; he made a good recovery, and in three months afterwards the prostate gland had reduced in size to almost its normal condition, all vesical symptoms disappeared, and the then emaciated patient is now in good health and says that he is perfectly happy.

CASE II.-Mr. -, of this city, age 65 years, has suffered severely for the last four years from the effects of an enormously enlarged prostate gland. While visiting in another city three years since he had retention of urine, could not be catheterized, and had to be aspi