the pain subdued, and the temperature influenced, we need have no fear of heart complication arising. Then comes the question: What are the best means, if there be any, to bring about this condition?

During the past three years I have been in the habit of packing most of my cases in a wet blanket, and afterwards rolling them up in dry blankets, so as not only to promote profuse sweating, but also to increase the temperature. This mode of procedure, which I conducted in a very indefinite manner, gave such good results that I thought carefully over the rationale of the system, and at once adopted a course of wet packing after the manner and with the success which I will relate. The procedure is simple. The bed is covered with Indiarubber sheeting; over this is laid a blanket which has been wrung out of hot water. The patient is then enveloped in the blanket, and covered with six folds of dry blanketing. By this the temperature is raised and profuce sweating results; the former, if need be, is assisted by the administration of brandy in half-ounce or ounce doses every hour, and the latter by giving freely warm milk and water. If the temperature exceed 102°, then the stimulant is unnecessary. My plan is to continue the treatment for three successive days; namely, for six hours the first day, four the second, and two the third. After the first pack, the patient is free, or nearly so, from pain; after the second pack, the pain has completely subsided; and, after the third pack, the sour smell usually disappears. In addition to the relief from pain and subsidence of acid secretions, the pyrexial state, with its attendant symptoms, will be found to decrease in direct ratio, and likewise the pulse. The secretion of urine will become more plentiful and the urea will dimish in quantity; yet, although the improvement is so marked in reference to pain, sweat, pulse, and temperature, the urine remains acid and loaded with lithates, and the tongue coated, for some days longer. It not unfrequently happens, especially in young people, when the weather is variable, that transitory pains return in one or more joints; but in almost every instance the pain has been subdued, if not by the first, by the second bath. In reference to cardiac inflammation, I believe that this treatment subdues it more rapidly than any other, rendering the valves less likely to undergo organic change.

But now comes a very important practical question. There can be no doubt that the packing process produces considerable constitutional disturbance. Under what circumstances should this treatment be adopted, and under what conditions is it not practicable? Every one who has had much to do with this disease must be conscious of the anxiety which it gives him when the temperature exceeds 105° or 106°, and especially when it is associated with the least sign of cerebral disturbance; and, as my treatment consists in elevating the temperature, it will be apparent that some care is necessary. Thus, according to my experience, it should not be adopted, I. If the patient suffer from incompetency of the aortic valves; 2, If there be much fluid in the pericardium from previous inflammation; 3, If the temperature be over 104°; 4, If the skin be hot, dry, and harsh, without the least tendency to sweating; 5, If there be extreme nervous

prostration from habits of drunkenness or other vitiating cause; 6, If the patient be pregnant.

Again, during the time the patient is packed, the following points must be observed: -1, If, after two or three hours, the patient become very restless, with a dry, non-perspirable skin, I should advise the treatment to be discontinued; also, when the temperature exceeds 105°; 2, If the temperature do not rise, and the patient be sweating freely, give half an ounce, or even an ounce, of brandy every hour in warm milk and water. Thus we have to secure profuse sweating and a mean temperature of 104°; we have to guard against a dry skin and a temperature over 105°. DR. THOMAS S. Dowse, in British Medical Journal.

ON THE RELIEF OF TOOTHACHE BY BICARBONATE OF SODA. - I once read somewhere, but cannot now refer to the passage, that toothache might be relieved by holding solution of bicarbonate of soda in the mouth.

A very severe case in the person of a boy came before me lately, and an open molar tooth was the source of the trouble. I tried to afford relief by rubbing chloroform outside the cheek, and by putting some on cotton-wool inside the auditory meatus. These procedures failed. I next placed a plug of cotton similarly saturated into the cavity of the tooth. This also failed to give any relief. I was surprised at this, as I had frequently thus used chloroform with success. I next saturated a small plug of cotton-wool with pure carbolic acid, and inserted this into the tooth-cavity. No abatement of the pain followed. I again tried chloroform, but in vain.

As a last resource I employed a solution of bicarbonate of soda, and to my astonishment the pain ceased almost suddenly, and complete relief was secured. I suppose I put about half a drachm into an ounce of water.

This solitary case seems worthy of record, as it may lead others to try the method adopted here. The remedy is within easy reach, and is very simple It is difficult to offer an explanation of the modus

operandi in the above case.

A mouthful of cold water will sometimes prove sufficient to remove the pain in toothache. I cannot now remember whether I tried this plan before using the solution of soda. Bicarbonate of soda is, however, a decidedly sedative remedy in certain conditions, and in proof of this may be mentioned the relief afforded by it in irritable conditions of the stomach, and in the itching of eczema

It struck me as noteworthy that a somewhat feeble alkaline solution should produce so decided an effect after the application to the sensitive dentine of a powerful agent like carbolic acid. If the toothache is excited by unhealthy (acid) saliva or buccal secretion, it becomes intelligible that an alkaline solution should rectify this.

In a future case I shall at once employ a warm solution of bicarbonate of soda, and thus I shall look for an unequivocal result. It would also be well to test the reaction of the saliva and of the buccal mucus in cases of toothache, with a view to ascertain their possible influence upon the surfaces of carious teeth.

The pathology of saliva is as yet, so far as I know, an uncultivated field, but I believe, if it be looked for, that this secretion will be more often found to possess an acid reaction than is generally believed or taught; and I also think that useful therapuetical hints may be gathered by the employment, at various intervals, of litmus paper in the mouth in many cases of dyspepsia and chronic disease. -DR. Dyer DUCKWORTH, in Practitioner.

DEATH OF URI CARRUTH. POST-MORTEM EXAMINATION. Uri Carruth, the Vineland editor, who was shot on the 19th of March last by C. K. Landis, has finally succumbed to the injuries then received, and died on the 24th of October, of cerebral abscess, having thus lived over seven months with a bullet nearly a half inch in diameter lodged within his cranial cavity.

The history of this case, from the time of the shooting until it passed from the hands of Dr. Tuller, has already been given in the pages of the Journal. From that time until death, the case was in charge of Dr. Brown, of Vineland, and no history of the symptoms or treatment during this period has yet been given. Under the internal use of arnica, with care in keeping the external wound open, and persistent horizontal posture, for securing perfect drainage, the case progressed with few unfavorable symptoms until the 26th of May, when "it was decided that the patient had so far recovered from the immediate effects of the bullet as to be in a state of convalescence, and that the primary dangers arising from the wound and from the presence of the missile in the cranial cavity were passed."

From this time the patient continued to improve in strength, and some time in the summer went up into New York State, where he spent several weeks, finally returning to Vineland, apparently still in an improving condition. While in New York State negotiations were commenced with Mr. Landis for the settlement of any claims for damages to which Mr. Carruth might be entitled After his return these negotiations were continued under circumstances calculated to keep Mr. Carruth in a continued state of worry and excitement. Under this his health rapidly failed, and, seized with convulsions on the evening of the 23d of October, he died early on the morning of the 24th.

In answer to a telegram we took the early train for Vineland on Monday, the 25th, for the purpose of making a post-morten examination. We found present many of the physicians of the surrounding country, with Dr. S. W. Gross, of Philadelphia, who made the first critical examination and dressing of the wound of Mr. Carruth. post-mortem examination gave the following results:

:

The

Body in good, plump condition; fair muscular and adipose development. Posterior surface of body showing gravitation of blood beneath skin. Cornea of right eye slightly collapsed from absorption of aqueous matter; left eye more plump. Point of original wound still open, and exuding bloody serum. Upon turning aside scalp, blood-vessels in posterior position, and in neighborhood of wound, much congested from gravitation. A portion of the ball was then

found about two inches below wound, between scalp and bone (it was a flattened strip, about one half inch broad by three quarters long). Original hole in skull partially filled up with fibrous matter. On opening the skull it was found of average thickness, pierced by a round, smooth hole at entrance of bullet, one inch to right of occipital protuberance, and one half inch above groove of right lateral sinus. Vessels of dura-mater much congested; opening in dura-mater made by the passage of the bullet closed over by a thin membrane; inner surface of dura-mater closely adhering to pia-mater about the region of the wound. Softening of gray portion of brain in region of the wound. Wound in brain substance firmly closed up. Vessels of piamater much congested; adhesion of the falx and upper surface of tentorium to posterior lobe. The removal of upper surface of right hemisphere of brain opened into an abscess, filling up the greater part of the posterior lobe with about two ounces of thick, greenish-yellow pus. A second abscess was then found near the point of entrance of the bullet into brain substance, smaller, and just below the other. A third abscess, lower still, was then found, all being lined by dense pyogenic membrane, and entirely isolated from each other. Just here the bullet could be felt in the dura-mater, and was found immediately after, incysted in the tentorium, beneath the posterior lobe of right hemisphere. It bore its original shape of a conical bullet, the cavity being still shown where the charge lodged. One of its sides was ragged and deficient, from having lost the portion found in the neck, which had been torn off in its passage through the skull. The missile was found about one and a half inch from point of entry, a little below it in direction, and more to the left. Marked congestion of the pia-mater was next noticed about the floor of the fourth ventricle, particularly on the right side. Right optic nerve smaller and of less consistency than left. No injury to base of skull. The cerebellum was found entirely uninjured by the ball; moderate softening of the crura of the brain, and of the large ganglia at base was also noted.

The examination of thoracic cavity showed muscular walls of heart flabby; otherwise, heart normal. Blood feebly coagulated. Lungs unusually healthy, free from adhesions at any point, but showing great hypostatic congestion of posterior portions. Abdominal organs all healthy.

The result of this examination explains several features of this case that could not otherwise have been well understood. First, the extreme ecchymosis about the right eye was not the result of fracture of the orbital portion of frontal bone, as was thought might have been the case, but was caused partly from the fall on the face, and probably largely from a diffusion of blood beneath the tendon of the occipitofrontalis muscle, from the wound at the back of the head. Second, the direction of the ball was not directly forwards from the point of entrance, but a little to the left, its course being arrested at the union of falx and tentorium, at which point it was found encysted. Third, the fragment of bone removed at the first dressing was probably driven forwards in a direct line, lodging in the posterior lobe, and

Fourth,

was the principal cause of damage to the brain substance. the impaired sensibility of the left half of the retina of each eye was the result probably of increased pressure rather than of any injury of the optic ganglia or tracts of the right side. Fifth, the injury being confined to one side of the brain, as that organ is double, either hemisphere acting independently, although in harmony with the other, the intellectual operations were merely embarrassed, not destroyed.

The coroner's jury, which held an inquest immediately after the post-mortem examination, returned a verdict, in effect, that Mr. Carruth met his death from the effects of a gun-shot wound received at the hand of Chas. K. Landis. The trial is expected to come off in January. Am. Jour. of Hom. Mat. Med.

ONE of the soda lakes of the Laramie plain presents a crystallization five feet deep, over ninety acres of surface.

AN apparatus for washing smoke, and so depriving it of its character as a nuisance, is in operation at a factory at Menilmontant, Paris. A fine shower of water, travelling in the direction of the smoke, and at five times its velocity, is projected into the chimney, where it mixes with the smoke, taking up the soluble gases and precipitating the impurities carried up with the smoke by the draught. The foul water is discharged into a cistern where it is collected and a fine black paint is got from it.

VIENNA YEAST The Vienna bread is reputed to be the best in the world. It is said to owe its superiority to the peculiar yeast employed, which is also used in the manufacture of the celebrated Vienna beer. This Viennese yeast. according to the London Chemist and Druggist, is prepared in the following way: Three kinds of grain, namely, Indian corn, barley, and rye (all sprouting), are powdered and mixed, and then macerated in water at a temperature of 65° to 75°. In a few hours saccharification occurs. The liquor is then racked off and allowed to clear, and alcoholic fermentation is set up by the help of a minute quantity of yeast. As fermentation progresses the globules of yeast reproduce themselves by a species of budding, engendering at first very small globules. but these rapidly increase in size. Carbonic acid is disengaged during the process with so much rapidity that globules of yeast are thrown up by the gas, and remain floating on the surface, where they form a thick scum. This scum is carefully removed, and constitutes the best and purest yeast. When drained and compressed by a hydraulic press, it can be kept from eight to fifteen days, according to the season.

PROGRESS OF HOMEOPATHY IN LIVERPOOL. Last night a conversazione of homeopathists was held at the Homœopathic Dispensary, Hardman Street, for the purpose of meeting Dr. Talbot, of Boston, and Dr. Ludlam, of Chicago, United States of America, who are on a visit to this country, and during the last two or three days have been visiting the medical institutions of Liverpool. Amongst those