after all, was the remedy so far fetched, for during the Peninsula war, a common practice was to administer opium and ether to the affected soldiers, not as a soporific, it is true, but as a strong stimulant antispasmodic. G. D., tertian intermittent, cold stage began about 8 a.m. 22nd September. The day of fever should have com, Dij. chloral hydr. given at 7.45 a.m.; fell asleep and continued so for about two hours; 24th-Repeated, fell asleep fifteen minutes and slept soundly for an hour. 26th. Repeated chloral as before. 28th.-No chloral. 30th.-Has hitherto had no attack; has escaped four paroxysms. But this morning he had a seizure about the usual time. It was, however, mild; cold stage slight, not much fever after, and no sweating. I now gave over the case to my successor, Dr. Fenwick, who, I was told, put him subsequently upon quinine, under which the patient sufficiently recovered to leave the Hospital. Fortunately for chloral, if it failed, it was no wonder and it failed in good company. No wonder, for the man had had the disease off and on during twelve months; the longest interval he had been free from it was two months, the recurrences often ensued in a week or two; he had marked paludal cachexia, deranged innervation, and enlargement of the spleen. If chloral failed so had everything else that was tried before, and in the company was quinine, which he had freely taken. And I have no doubt, till his blood, nervous system and spleen are first rectified, no remedy will be more than temporary in its benefits. How far chloral may answer in ague, in recent and uncomplicated cases remains to be seen. In these I have hitherto had no opportunity of giving it a trial. In asthma, chloral will yield relief to the urgent distress. Among the notes I took is the case of B. H., æt. 45, admitted 9th August, 1870, with chronic bronchial catarrh attended with pseudo-asthma. After a trial of cannabis, lobelia, prussic acid, &c., and subcutaneous injections of liq. opii. sed. which afforded more or less relief, but only for a time, she was put upon chloral. She was kept upon it longer than the others, because it seemed the most useful; the cough became less often, breathing more easy, rhoncus and sibillus, which before were heard, while standing about her bed, could only be heard by the ear near the chest and over less extensive space, and she continued for a week at a time without a paroxysm of dyspnea; she had no other medicine except a sharp liniment to the chest, and an occasional aperient. She was still in hospital when I left. By others chloral has also been used in tetanus, chorea, nervous affections, insanity, fevers and surgical cases. In tetanus 3 ss. has been given every four or five hours. Recoveries after it have been recorded, and so also have deaths. It subdues the spasms while its effects last causes extreme muscular relaxation, and leads to sleep. In chorea small doses repeated during the day for one, two or more weeks are said to afford marked benefit. In nervous affections generally it is favourably spoken of. In acute mania it has been found successful as a safe hypnotic, Dij. to 3j. are required for the purpose. It is represented as not having failed in 1 per cent of the cases. In puerperal mania it has also been resorted to advantageously. And in the paralysis of the insane it is very serviceable where the patients are destructive and violent. In fevers it has been selected when the patient is wakeful and suffers from want of sleep. In re-instating "tired nature's sweet restorer," it serves greatly to maintain the strength of the patient, and to enable him better to withstand the violence of the disorder, so that fatigue and exhaustion are much less likely to be extreme, especially in delicate constitutions. In surgical cases it has been extensively employed in Edinburgh, particularly after severe accidents and capital operations, the object being not merely to afford sleep, but to give ease and soothe irritation. And, lastly, it has also been prescribed in protracted labour from rigid os uteri. And, lastly, chloral has been used as an ANTIDOTE. Dr. J. H. Bennett records several experiments which serve to demonstrate that, after a fatal dose of calabar bean had been administered to a rabbit, the exhibition of chloral appeared to prolong life, though death ultimately supervened. And Mr. Groves narrates a case of poisoning by strychnia in a dog, where about an hour after it had been swallowed, chloral was employed. Two doses were given and the animal recovered. ADMINISTRATION.-Chloral should be given in solution. Owing to its unpleasant flavour and pungency various agents have been advised in combination, e. g., syrup of tolu and aq. menth pip. (Squires); a few drops of chloroform or spt. menth. pip. (Ogle); Glycerine answers very well. I have often ordered it with mucilag acaciæ. The doses I have mentioned in which chloral hydr. is to be prescribed in different cases refer of course to the substance in its solid state. Preparations of it such as the syrup made by Ferris & Co., of Bristol, or others, when selected, must be apportioned so that each dose will contain an equivalent quantity of chloral to what would be required if the latter were dispensed in the crude state. I mention this as a mistake, apt to be made, is to prescribe the syrup in doses in which chloral in substance is ordered to be given. When chloral was first introduced it was sold at a very high price. A year ago last fall, in England, 12s. were exacted for an ounce. The price, however, soon fell. Last summer the same quantity could be purchased there for 1s. 6d. It is imported into Montreal direct from Berlin, and sold wholesale to druggists in amounts of 28lbs. each, at the rate of $3.25 or $3.50 per lb. When it could only be obtained retail at 50 cts. per oz., I procured for our Hospital a supply at half this price or at the rate of $4 per lb. Observations made upon the action of Chloral Hydrate in Typhoid Fever under Dr. Wright. By W. G. Ross. The fever gradually declined from the commencement of the examinations. The pupils were dilated for a few days about the 10th, but were neither then nor afterwards affected by the Chloral. The patient always complained of a burning sensation in the throat after taking the draught, but was so stupid that any alteration in the sensations could not be made out: he could not even tell at what time he awoke. Twerty grains dissolved in an ounce of water were given at each experiment. The first line of figures denotes the observations made just previous to giving the Chloral; and the remarks are the appearances noted at the time on the line of which they stand. II. CASE OF GEORGE MITCHELL. Sept. Time. Temp. Pulse. Resp. P.M. 22nd. 6.00 1033 24 24 30 36 6.15 103 36 7.00 103 27th. 5.45 104 100 20 6.15 103 102 28tn. 5.30 104 34 Remarks. Complained of burning in the throat after the Chloral. Wandering in his mind during sleep, was awoke by the examination but went to sleep again during it. Woke up at this time and complained of great dryness of the tongue and throat. Sleeping uneasily with much starting. The respiration was jerking and irregular. Groaning and turning about during sleep. The respiration more jerking in character than at 6.15. Surface moist, woke up very thirsty, pupil not dilated. Drowsy and went to sleep during the examination. Groaning in his sleep. Respiration jerking and irregular, much like that of a child labouring under acute Pleurisy. Quite awake and feels none of the effects of the drug. J Sleeping lightly, as he awoke and went to sleep again Sleeping and breathing lightly and quietly. 112 30 Asleep, moaning and talking. 24 5.45 1033 98 6.00 103 Awake, does not feel drowsy, pupils normal. 7.00 104 106 32 5.45 1033 24 34 98 36 Moving about, groaning, and muttering during sleep which is quite sound. Is not sleeping but feels drowsy. Sleeping lightly and quietly. Sleeping quietly and soundly, sweating. The observations have been made at the height of the fever. The pupils were not dilated by the disease or the Chloral. The patient exhibited great aversion to the drug after its first administration, he said it burnt like whiskey, but did not at any time complain of sensation, similar to those produced by that stimulant, he used to speak familiarly of the draught, as you are bringing that whiskey again to-night." It frequently caused slight eructations, there was at no time marked hyperæsthesia. He generally awoke about 3 o'clock and was very restless until day-light. The first line denotes the observations made just previous to giving the Chloral (twenty grains to an ounce of water.) alid the remarks are stated on the line opposite the time to which they stand. Case of Epithelioma of the Tongue. Removal: subsequent return. By W. CANNIFF, M.D., M.R.C.S., ENG., Professor of Surgery, Victoria Medical School, Toronto; President of the Medical SectionCanadian Institute; late Vice-President Canadian Medical Associa. tion; Corresponding member of the Gynecological Society, Boston. John B, aged 42, a Scotchman, was admitted into the Toronto General Hospital on the 17th December, 1869, with Epithelioma of the tongue. The account he gave was, that about six months previous he noticed a small lump upon the right side of his tongue, about midway between the tip and the root. The tumour gradually enlarged and eventually ulcerated. He then applied to a druggist, who repeatedly applied caustic to the ulcer, which had the effect of aggravating its character. For some time past he had been under the care of a medical man in Toronto; but the ulcer had steadily increased. He admits that for many years he was in the habit of using almost continually during his working hours, a short lay pipe. He is not aware that any member of his family was ever affected with cancerous disease. Upon examination, a large ulcer with hard inverted edges and with cauliflower excrescence was found involving the right side of the organ, from near the tip to the root, and extending in the middle to the opposite side. He is a great sufferer, the pain being excruciating when he swallows. At a consultation of the Hospital staff, it was decided to remove the tongue. Consequently, on the 8th of January, 1870, the operation was performed. I was kindly and efficiently assisted by Drs. Beaumont, Hodder, Richardson and Geikie. A large number of the profession of Toronto was present. The mode of procedure adopted was to make an incision in the median line beneath the chin from the symphysis nearly to the hyoid bone, down to the floor of the mouth. Then, the ecraseur having been prepared, the chain was introduced doubled, by means of a needle and ligature, beside the femur. A strong linen ligature was then passed through the tongue well back, by which the organ could be drawn. forward and slightly upward. The chain being duly passed back over the tongue to the root, especially on the right side, so as to include the diseased mass, the instrument was set to work. Gradually the enclosed structure was strangulated, and finally severed. But little hemorrhage took place, which was readily controlled by pieces of ice placed in the mouth. The constitutional disturbance was very slight. Fluid diet of beef tea and milk, with a limited amount of stimulant, was regularly administered. The day following, he was for a while unable to swallow, but this difficulty soon ceased. The patient's recovery proceeded with no untoward event. After a layer of slough had been thrown off, healing by granulation rapidly followed. By the 27th January there was only a point unhealed. On the 11th of February the patient was discharged well. But upon the mucous membrane immediately anterior to the right anterior pillar of the fauces appeared a degree of induration not very assuring. In every other respect he was in excellent health, and could so far utter words as to made himself distinctly understood. He then went to the country and was not seen for a number of months. Upon the 14th December, 1870, he was again admitted into the hospital. He stated that for upwards of seven months he continued perfectly well; he then found a swelling in the floor of his mouth on the right side, (but at a place quite removed from that where had been noticed when he left hospital, a suspicious looking condition of the membrane.) After a few days the swelling resulted in the opening of an abscess beneath the |