form of a figure-of-eight, so as to allow free motion of the joint. [This bandaging of the arm is, in general, unnecessary.]

For the bandaging proper, take a piece of adhesive plaster, of about four inches wide, and apply one end to the inner side of the belly of the biceps, about the middle of the humerus; then carry it in front of the arm and around the trunk behind, coming around the right side and beneath the nipples, or mammæ, as the case may be. The plaster is not to completely encircle the arm, as that would girdle the circulation. The arm is now about parallel to the axis of the body, and cannot be brought forward. Next, a small compress is to be pressed up in the axilla. A second strip of adhesive plaster, as wide as the first, passes from the right shoulder around and across the back behind the lower part of the arm and beneath and without the elbow. By now pulling the loose end of the bandage forward, inward and upward, the first bandage retaining. the centre of the arm fixed in position as a fulcrum, the shoulder is carried upward, and on the principle of the lever, backward and outward, the point d'appui, in the centre of the arm, in conjunction with the axillary compress, securing the fulfilment of the indications. On making this traction the deformity, in ordinary cases, wholly disappears, to reappear the moment it discontinues. The same second plaster is then to be carried from the elbow, across the outer side of the forearm, flexed at an angle of about forty-five degrees on the arm, across the breast and back to the right shoulder. The ends of the fragments, instead of being an inch asunder, are now almost in apposition. "It doesn't hurt now, does it ?" Patient (very emphatically.)—" No, sir." A third piece of plaster passes around the wrist, suspending it, and then both ends pass over the seat of fracture, retaining a small compress there. This last plaster is commonly unnecessary. If the appliance be too tight, as indicated by thumping at the wrist, slacken it, or nick the plasters so that the circulation may not be interrupted. Stitch the plasters if there be a tendency to slip. One application of the plasters will commonly be all that will be required in each case.

By this method you may get a cure so perfect that, as has happened to me, you cannot persuade people that it was fractured at all, and cannot find its seat yourself. It is perhaps better to have some one see it with you, or allow the patient to go about untreated for a few days, until he is satisfied that it is really fractured. A fracture should be set the moment it occurs, if possible. In the case of the clavicle, it can be done at once, and that is an amen to the matter. Do not wait in fractures for nine days before doing anything, as was until recently the teaching of the schools. Another advantage of this method is, that by it we avoid

the irritative fever which is apt to follow fracture. Of the thousand and one inventions which I have tried, none has given such satisfaction as this, of which I have had a fifteen years' experience. I must disclaim all originality of the idea. The credit of it belongs to some one whom I heard propose it at a meeting of a medical society, and whose name I know not. For little children, there is none so good as this. Dessault's bandage, thirty yards long, entangles the young one in such a labyrinth of bandage, and requires such frequent adjustment, that using it you will be apt to conclude that it is a very bad fracture to treat, and had better be let alone.

With this treatment any one can go about and attend to his or her. business at once, and until union. I believe, that if perfect apposition be secured, union by first intention may take place in bone as well as in soft parts. Do the best you can; but always believe, in your own mind, that shortening need not necessarily occur.-New York Medical Gazette.

TREATMENT OF HEMORRHOIDS.

Dr. John H. Packard, Surgeon to the Episcopal Hospital, Philadelphia (N. Y. Med. Journal,) says, that one principle should govern us in all the palliative measures adopted in any case of piles: namely, to prevent straining. And this may be carried ont in various ways. Besides the adoption of a proper diet-table, embracing simple but nutritious food, well cooked, and not highly seasoned, there are four points to be attended to. By means of medicine we keep the bowels easily moved; 3 ss. or so of sulphur, mixed with cream or molasses, every morning before breakfast, will do this. Or by very small doses of Epsom-salts, by Vichy, Congress or Bedford water, we may accomplish the same end. The second measure is mechanical: the patient is intructed to have made a board, with an opening about five inches wide by fourteen long, to place over the ordinary privy-seat, which allows the nates to bulge down too much; this will in a great degree prevent the protrusion of the relaxed rectum. The third is the use of astringent suppositories, to be used after each stool. He has found the perchloride of iron, grs. j, ij, or iij, inade up with cacao-butter, to answer best, unless the piles are inflamed, when the acetate of lead is more soothing. The fourth element of the treatment is the employment of a hemispherical block of ivory or vulcanized rubber, about as large as half a billiard ball, attached to a spring of properly adjusted strength, and this again fastened to a belt. When in place, this supports the parts, and in cases of great relaxation prevents their descent in walking; the comfort thus afforded is very great.

CANADA

MEDICAL JOURNAL.

ORIGINAL COMMUNICATIONS.

Valedictory Address to the Graduates in Medicine and Surgery, Victoria University. Delivered on behalf of the Medical Faculty, by WILLIAM CANNIFF, M.D., M.R.C.S.E., Professor of Surgery. GENTLEMEN GRADUATES,—Along the pathway of life we find placed here and there events of more than ordinary importance-events which may change our course in one way or another, or which are as eminences from which we may not only obtain a more extended view, but proceed with greater ease and success. Our whole life is a series of marches, each of which prepares for that which is to follow. The road we travel is like an ascent up a mountain, the summit of which is reached by successively gaining one eminence after another. We graduate from infancy to childhood, from childhood to adolescence, from adolescence to early manhood, and thence to mature life, when the full development of the body and mind is reached. Then, again, the mind graduates in strength and power as days and years add to the stock of knowledge and culture. In education there is ever an upward bent, as the student proceeds from the alphabet and passes one elevation after another toward the summit of his Parnassus. There is a common road which many travel, but there comes a stage in the journey when special routes will be selected. Those who desire to become learned in the law turn into one path; those who seek to unfold the mysteries of nature, in another; and he who would. master the science of medicine turns into another, and pursues his course. Whatever be the way chosen, the student will still find a hill to ascendfrom the A B C of the science until a point is gained, when he ceases to be a tyro. Then, no longer an apprentice, he is called to discharge the duties of a master-workman.

You, young gentlemen, whom I address to-day, have reached this important stage in your educational life. To-day marks an important event with you. Ceasing to be boys you assume the duties of men.

HH

No

longer under pupilage you are now members of the profession of your choice. I congratulate you upon having attained your majority. I congratulate you not merely because you have graduated into manhood and in medicine; but that you do so at such an auspicious period of our country's history. The Dominion of Canada under Confederation has just reached man's estate, and has been clothed with the robes of national power, and endowed with the functions of national life. She has received a diploma to practise the science and art of independent existence; and thus she has commenced to work out the grand problem of national success, just as you have been furnished with authority to work out your independent personal destiny. It is, I say, a happy time to be called to work and act for yourselves, as your country has entered upon the high way of prosperity. As I believe this Dominion will be fully able to meet the expectations of the most hopeful and trustful, so I believe you Graduates in Medicine, of Victoria College, will be found equal to the duties and responsibilities which await you in professional life, and that you will, like your country among the nations of the world, stand among your fellowmen and brother practitioners, at all times honest, just, upright, and inferior to none. But in order to be successful you must not only make use of your present acquirements, you must ceaselessly endeavour to add to your store of knowledge, not of medical lore alone, but of all knowledge which will assist to equip you for the duties of life. Although you now cease to be tyros and pupils under professors, you cannot cease to be students. It is one of the conditions of success in the medical profession that constant application of the mind be practised. The field of book knowledge, and of nature, must be both diligently cultivated.

Upon the elevated ground you occupy to-day, you may profitably look upon the past, and forward to the future, while you fail not to gratify, as you are justified in doing, your mind by contemplating the surroundings of the present. I have no doubt, in the past, during the time you have been engaged in the pursuit of the principles of the science of medicine, you have often experienced hours of hopelessness, of despondency, almost of fear. The ordeal through which you have passed before the College Examining Board, and the Board of the Medical Council, is well calculated to make one thoughtful, and consider whether he can possess himself of the knowledge, the power, and the courage requisite for successful passing. It is a cause of great gratification equally to us all, both teachers and students, that you have not been found wanting. Wanting neither courage nor success. I now speak of the graduating class of Toronto, and I have no doubt the same can be

DIAGNOSIS BY EXAMINATION OF URINE IN OBSCURE FORMS OF URINARY DISEASE.

BY SIR HENRY THOMPSON, Surgeon and Professor of Clinical Surgery to University College Hospital.

I wish to call attention to a mode of obtaining a diagnosis in some rare and doubtful cases of disease of the urinary organs, when all other modes have failed. I described it first in my clinical lectures at University College Hospital, some years ago, as a means of observation which had never to my knowledge been recommended or practiced, and which I had adopted systematically, and which I have since found of extreme value in some exceptional instances. Thus, for example, we not seldom meet with a patient whose urine, usually containing a small or varying quantity of blood and pus, presents more or less albumen, but relative to the precise origin of which it is desirable to be certain. Some of the deposit produced is of course due to the admixture named; and while we may be right in believing the quantity to be equal only to the blood and pus in the urine, we cannot be certain whether some of it may not be due to renal changes. In such a case, the other signs, and the symp-toms also, are often insufficient to enable us to say whether they are due solely to vesical disease or to pyelitis, or whether there may be some renal affection, not to say constitutional albuminuria, complicating the conditions named. On the other hand, the symptoms may apparently indicate only an affection of the bladder; there may be no symptom of disease involving any higher portion of the urinary tract; nevertheless, the experiment to be described may prove the kidneys to be almost solely the seat of the malady. Few cases present more of obscurity than some of those with the characters thus briefly indicated.

The proceedings may be described as follows. A No. 6 or 7 flexible catheter is introduced into the bladder while the patient is in an upright position, and the urine drawn off is placed in a vessel apart. By means of an elastic gum-bottle containing a few ounces of warm water, the bladder is washed out two or three times, with about an ounce or two at a time, until the outflowing fluid is perceived to be quite clear. The catheter being left in situ, fresh urine from the kidney, untainted by any admixture, will now pass by drops into a test-tube placed to receive it; and a specimen, therefore, of true renal secretion, unqualified by vesical products, will be furnished in about five minutes, sufficing for a chemical analysis and useful to a certain extent for microscopical observation. By this simple process I have been enabled to solve the question of disease of the kidneys in some cases in which hitherto doubts as to their implication existed; and have often had the satisfaction of demonstrating that