letting in pneumonia was not often practiced by him, because the opportunities were small for treating the disease at the onset of the attack.

Dr. Weigershetm recommends, before the Berlin Medical Society, the employment of minute doses of ipecac, with the advantage to the physician of being able to regulate the amount of vomiting that shall occur. He triturates three grains of ipecac with one or two drachms of sugar, divides into twelve powders and gives one in a spoonful of water every five minutes until vomiting is produced. No drinks are allowed, and usually the desired effects are obtained after the third or fourth powder.

At the University College Hospital, in the latter part of September, Mr. Erichsen and Mr. Berkeley Hill had the opportunity of testing, in two cases, the combined use of the three important recent modifications in surgical practice, viz: torsion, by the artery forceps, caustic and antiseptic lotions.

After the removal of two diseased breasts, every minute bleeding orifice was closed by torsion, the wounds were washed with chloride of zine, and, after the flaps were brought together, strips of linen steeped in carbolic acid and oil were carefully applied. The linen strip next to the healing surface was allowed to remain permanently, while the superjacent layers were renewed daily. The surgeons of this Hospital are well pleased with the results of the modifications, having found that, since their adoption, pyæmia, which was formerly of frequent occurrence, has now entirely disappeared.

Mr. Rouse, at St. George's Hospital, finds the proportion of one part of carbolic acid to forty of water too strong as an application to chronic ulcers of the leg. As a substitute, he employs two drachms of carbolic acid to a pint of lead lotion, with the effect of destroying all odor and stimulating the indolent granulations.

For chronic eczema, where there is not much inflams mation, he uses a drachm of carbolic acid, two drachmof lead lotion, one ounce of glycerine and eight ounces of water. "This stops the itching and smarting in a remarkable degree.

Mr. Henry Lee, surgeon to St. George's Hospital, reports twenty-two cases of excision of the larger joints, with only two deaths. He attributes his success, first, to the fact that a majority of the patients were children and the excisions of the ends of the bones were made before the epiphyses were united to the shafts of the bones, and, second, to the fact that, in those who were adults, the ends of the bones had become consolidated by previous inflammation.

In the two fatal cases there was diffuse suppuration in the surrounding soft parts and purulent infiltration of

the shafts.

M. Herard, of the Academy of Medicine of Paris, reports favorably upon arsenic in certain forms of tubercular phthisis. He and M. Moutard-Martin prefer the arsenious acid in pills or granules, gradually increasing the dose, and occasionally suspending the treatment for a few days.

Benj. Ball, M.D., reports, in the Times and Gazette, three cases of locomotor ataxia, in which disease one or more large joints were affected with arthritis.

In one of the cases, dying from other causes, the bones composing the left shoulder-joint were carious and the cartilages were destroyed.

Heretofore, such a complication has been mistaken for the effects of rheumatism; but he considers it a true spinal arthritis.

Eggs are preserved on a large scale in Paris by plunging into a cauldron of boiling water a colander containing one dozen and allowing them to remain for one minute. This immersion coagulates a thin layer of albumen on the surface and the admission of air is thereby prevented.

Dr. N. U. McVoy, of Sierra Leone, West Africa, writes through the Times and Gazette, to Sir Arthur E. Kennedy, Governor General, of the beneficial effects of carbolic acid: "first, as a deodorizer and disinfectant; 2d, an antiseptic dressing for wounds and foul, sloughing and phagedænic ulcers; 3d, as a stimulating dressing for weak or unhealthy sores."

He uses it in the form of a liquid and powder for the

urinals and water closets and upon the floors of the wards and in the dead house. He claims that it diminishes the secretion of pus from suppurating wounds.

The Medical Times and Gazette does not admit the fact "that seems now to be admitted on all hands," that eczema has resulted from the use of colored socks. In spite of the testimony of Mr. Webber, the editor is disposed to accept the opinion of Mr. Crookes, F.R.S., to the effect that the dye does not contain arsenic and at the same time suggests that Mr. C.'s "somewhat brilliant and fast orange dye" is a mysterious entity.

He says further that "in our last week's journal a case is reported in which the wearing of well-washed socks (after the abandonment of the colors) was followed by a return of the eczema.

Dr. Hawksley, the consistent advocate of the dry earth system of disinfection, has written a triumphant letter to the Times, in which he says: "Its impracticability will be found, on trial, like Columbus' egg, or the quiet chuckle over Lardner's dicta concerning steam navigation in America," no impracticability.

[The dry earth system is well adapted to densely populated districts which have not already been supplied with the general water system of sewerage. There are corners in every city and in many villages, that could be rendered more salubrious by a general adoption of the dry earth system.-H.]

Mr. John D. Hill, of the Royal Free Hospital, has recently removed a large invaginated sequestrum from the femur of a man, aged 23, of strumous diathesis, who had submitted to amputation two years before. Upon exploration, he found a cap of new bone covering the sequestrum, two small cloace admitting the probe.

[Experience in military surgery shows that it is safer to the patient to allow the sequestrum to become fully detached, before any attempt is made to remove it. When a secondary amputation of the end of the bone is resorted to, for the relief of caries, or the removal of an incomplete necrosis, the patient will most likely succumb from increased drainage of pus, or from some of the numerous complications of such injuries.-H.]

Prof. Lionel S. Beale, F. R. S., physician to King's College Hospital, in an introductory address to the medical class, asserts that while many of the greatest surgeons and physicians have been remarkable for their devotion to this branch of medical science, nevertheless, the importance of physiology to medicine, is still very much underrated.

He says further, that "anatomy, chemistry and physiology are subjects with which every one should be acquainted before he commences the study of medicine and surgery;" and further still, that "it is obviously impossible that any one can really learn anything at the bedside until he has acquired such preliminary elementary knowledge."

Mr. Henry Lee, in a paper read before the Medical Society of London, Nov. 2, thus describes his method of performing the medio-lateral operation of lithotomy: "The patient is placed in the ordinary position for lithotomy, and, a grooved staff having been introduced, an incision is then made in the median line of the perineum from before backward. This incision should extend through the posterior half of the perineum, terminating two or three lines in front of the anus. From this point the incision is continued for the quarter of a circle round the front and left side of the rectum. The finger of the left hand may then be put into the wound and the rectum pressed back, whilst an additional touch or two with the knife separates it still further from the parts in front. The forefinger of the left hand is now passed into the rectum, and the knife, with its back toward the bowel, is passed at the posterior part of the central incision, and in the median line, into the membranous portion of the urethra. With the finger as a guide, this is done with great case and certainty. A bistoury or knife, with a probe at its extremity, is then passed into the bladder. The blade of the knife is then directed toward the patient's left side and somewhat backward, and, as it is withdrawn, the heel of the knife passes in the direction of the original incision through the skin. The point of the knife remains very nearly in the median line. A free external incision is thus produced, involving no important parts, with a small opening into the bladder. The urethra being opened, the median line is reached with the greatest facility with the finger and the incision

into the bladder is in the same way very easily dilated. The forceps, or any other instruments that may be used, are also introduced more directly into the bladder, than in the ordinary lateral operation. In this operation, all the usual accidents and difficulties which are likely to occur in lithotomy are guarded against. With the finger in the rectum as a guide, the urethra may be opened without difficulty and a probe-pointed bistomy, being guided by a grooved staff, cannot fail to enter the bladder. The incision into the prostate gland is made from within outward and this he (Mr. Lee) considered an advantage. An incision made in the opposite direction partakes more or less of the nature of a stab, and the point of the knife, even when guided by the most skillful hand, will sometimes wander from the groove in the staff."

CLINICAL RECORDS.

'Ex Principiis, nascitur probabilitas: ex factis, vero veritas."

ART. I.-JOINED TWINS; THE OBSTETRIC AND SURGICAL MANAGEMENT, WITH REMARKS. By A. B. Cook, A.M., M.D., Professor of the Principles and Practice of Surgery, Kentucky School of Medicine, Louisville, Ky.

In the human organism, a monstrosity-something out of the common order of nature-has, in all ages, been of frequent occurrence. We would exclude from this general definition, abnormal developments, such as clubfoot, supernumerary toes and fingers, cleft-palate, &c., and limit the term to the complex anomalies of conformation. In the days of mythology, monstrous births were regarded as omens of evil, the displeasure of God or the