the rheophores to the scrotum. He believes that, though these methods of treatment have been followed by some success, they are not calculated to supersede the use of injections of iodine or of alcohol, drainage, &c. They do not carry out the generally recognised indication, to produce sufficient inflammation of the tunica vaginalis to induce adhesion and obliterate the cavity. Dr. Rodolfi states that he has gained this object in the following manner. The hydrocele having been tapped, and the contents drawn off, a copper probe, about eight inches long, covered with an isolating material, except at the two ends, is introduced through the opening made in tapping. The outer end is placed in connection with a copper wire covered with silk, which is attached to the negative pole of a Grenet's three-pile battery, or a Bunsen's four-pile, charged with a solution of bichromate of potash (water 800 parts, bichromate of potash 50 parts, sulphuric acid 50 parts). The positive pole, by means of a wire attached to the rheophore, with a sponge dipped in solution of chloride of sodium, is applied to the scrotum, near the inguinal region. The operator then touches successively with the point of the probe the whole internal surface of the tunica vaginalis, moving the positive pole at the same time. The application should be made for six minutes in a child, ten in an adult, twelve in an old person. The number of piles used should be two for children, three for adults, and four for old men; and care should always be taken to test the activity of the instrument by the galvanometer. The operation generally causes little or no pain. After the operation, a diachylon plaster is placed over the seat of the puncture. In children, some swelling of the testis and redness of the skin follow in eight or ten hours; in adults, the local reaction appears later. The swelling is painful on pressure only, and subsides in ten or twelve days. It is not attended with fever or loss of appetite. For some days, Dr. Rodolfi applies linseed-meal poultices; after which, he uses frictions of mercurial ointment with belladonna. He does not report any cases, as, he says, he wishes to have time to prove whether the cures are permanent before doing so: but in the meantime he begs surgeons to make a trial of the method he describes. (London Medical Record, No. 25, 1873.)

Extracts from British and Foreign Journals.

Comparative Therapeutic Value of the Salts of Protoxide and Sesquioxide of Iron.-Iron, says Mr. J. Creuse in a paper read before the College of Pharmacy of the city of New York, has been used in medicine from times immemorial. Metallic iron, green copperas, iron rust, carbonate of iron, bole Armenia, are mentioned by the oldest writers on medicine and pharmacy; but in former times little importance was attached to the peculiar form in which iron was administered. Some fifty or sixty years ago, a decided preference began to be shown for metallic iron, finely comminuted, and for the protosalts of iron. It was thought then that the easy solubility of those preparations in the stomach was a great advantage, and that theory gave rise to a number of officinal remedies like iron reduced by hydrogen: Vallet's mass, protiodide of iron, &c. Of late years, however, especially since the discovery of the citroammoniacal pyrophosphate of iron by Robiquet, the salts of the sesquioxide of iron have been steadily growing in favour. It has been argued with reason that since iron in the human economy is invariably found in the shape of sesquisalts, such compounds should be preferred to all others, whenever iron is indicated. It is always in the form of sesquisalts that iron exists in all vegetable and animal substances which compose human food, and metallic iron or its protosalts cannot be mixed with the simplest aliments without completely decomposing them. Protoxide of iron is as unyielding as it is unstable; when you have combined it with strong acids, you can go no further with its salts, you can make nothing of them, not even an alum. Sesquioxide of iron, on the contrary, is a perfect Proteus; sometimes a base, sometimes an acid, it is always ready to enter some combination or other on the slightest provocation. Mr. Creuse has himself demonstrated that nearly all the insoluble sesquisalts of iron can be combined with the alkaline citrates, forming soluble and tasteless compounds to which he gave the name of quadruple citrates; and more recent experiments have shown him that other vegetable salts besides the citrates possess also

the same property, and that not only the insoluble but also the soluble sesquisalts of iron could form similar combinations. He therefore lays down the general rule that all the salts of the sesquioxide of iron without exception, soluble or insoluble, form combinations with all the alkaline citrates, tartrates, and oxalates; such combinations are invariably green, whatever may be the colour of the iron salt: they are all soluble in water, and nearly insoluble in alcohol; they are all free from ferruginous taste, all perfectly stable and miscible with preparations of Peruvian bark without decomposition. In all of them the presence of iron is so disguised as not to be detected by chemical reagents, unless after the addition of strong acids or of sulphuretted hydrogen, both of which destroy the combination. Mr. Creuse then proceeds to describe the mode of manufacture of the tasteless combinations of the alkaline citrates with iodide, chloride, sulphate, and nitrate of iron. (Pharmaceutical Journal, No. 153, 1873.)

Diphtheritic Endocarditis.-Prof. Eberth states that in his researches on bacteritic mycoses, he has observed a special disease of the cardiac valves in pyæmic subjects, and considers that this is due to the small organisms which he has recognised as exciters of secondary suppuration. The disease presents the same characters as ordinary rheumatic endocarditis, and its seat is identical. Under the microscope the deposit appears to be chiefly made up of fibrin threads with large quantities of sphærobacteria, resembling those found in the diphtheritic condition of a wound and in embolia of the kidney. That the bacteria developed in the blood should congregate together and remain adherent to somewhat roughened surfaces of the heart is no more surprising than that the colourless corpuscles should be similarly found to form large coagula, and Eberth is therefore not inclined to agree with Hüter, that they have been transported in mass from the primitive focus of pus. Eberth does not agree with Klebs in regarding the diphtheritic fungus as a separate species, and in holding that both septicemia and pyæmia proceed from another fungus, the microsporon septicum, but thinks that this fungus is identical with the microsphæra of diphtheria. Eberth, however, considers a distinction may be drawn between the septicæmic and the pyæmic diseases, since under the former are included those disturbances which may arise from chemical poisons, whilst the latter are caused only by bacteria. He agrees with Hüter in attributing great importance to diphtheria in the production of pyæmia, and the malign ulcerative endocarditis he describes in this paper he regards as strong corroborative evidence of his view, since it is quite independent of traumatic diphtheria, and constitutes a perfectly independent process; pre

NO. LXIII.

P

senting, however, all changes of pyæmia.

the symptoms and characteristic morbid (Virchow's Archiv, lvii. 2, 1873.)

Conium in the Treatment of Insanity.-Dr. Daniel Kitchen, assistant physician to the New York State Lunatic Asylum, states that during the past eighteen months he has been pursuing special investigations with conium in the treatment of insanity, aided by the thermometer and sphygmograph. The preparations used were the succus conii, an imported article prepared by Ransom and Co., and the fluid extract, made by Squibb, of Brooklyn. The dose of the succus which will produce the physiological action is from a drachm to an ounce, according to the motor activity of the patient; men require larger doses than women. The dose of the fluid extract is from twenty minims to a drachm; twenty minims of the extract prepared by Squibb is equal to about a drachm of the succus conii. Some preliminary experiments upon a healthy person showed that in these doses conium lowers both the temperature and the pulse without any apparent effect on the respirations. In the investigations carried on in the State Lunatic Asylum its effects were carefully observed in 150 different patients, embracing cases of mania, melancholia, and hysteria. The following physiological effects are observed in from ten to twenty-five minutes after a full dose is taken:-1, Suffusion of the eyes and injection of the conjunctivæ ; 2, giddiness and sensation of weight along the orbit; 3, dimness of vision and dilatation of the pupils; 4, inability to sustain any mental effort; 5, languor, muscular weakness, with a strong desire to assume a recumbent posture; 6, a dragging sensation in the limbs; 7, pulse and temperature lowered; 8, gentle glow of perspiration over the whole body; 9, usually in half an hour the patient is asleep. It appears that upon the motor centres in the brain Dr. Kitchen has failed to discover any direct hypnotic effect, as in chloral hydrate, yet sleep follows very rapidly, as it almost always follows muscular relaxation, and in a natural way. When large doses are given the action upon the muscles is so quick that the patient is scarcely able to prevent himself from falling by supporting himself with his hands. Its effect is the counterpart of that of strychnine, quieting and conserving the nervous energy, and leaving the muscles to sink into rest. Dr. Kitchen has frequently observed the strong and powerful man, in mania and melancholia, after taking a full dose become quiet, and this state is soon followed by prolonged sleep, from which he awakes much refreshed. Full doses, however, must be given, and the preparation must be good. Dr. Kitchen administered it in eleven cases of epilepsy of long standing, complicated with dementia. The fits were lessened somewhat in number and

severity, though none were entirely relieved. In several cases of facial erysipelas with great restlessness, while bromide of potassium proved of little use, conium relieved pain, and sleep followed. According to Professor Mitchell, the addition of half a grain of blue pill has a most salutary effect. A few cases of sciatica and of migraine dependent on dysmenorrhoea received great relief from conium. In hysteria with epileptiform convulsions, conium given in full and repeated doses afforded much benefit. An important point in respect to conium is, that if it does no good it does little or no harm, as it has but little appreciable effect on any of the secretions; and as it does not act on the brain, it may be safely given in all febrile cases. Dr. Kitchen gives an appendix of twelve cases, showing its effects in various forms of disease. (American Journal of Insanity, No. 4, 1873.)

Inequality of the Pupils in Unilateral Affections of various parts of the Body. A paper on this subject appears in Allgemeine Wiener Med. Zeitung, by Dr. F. J. B. Roque. He observes that several years ago Baillarger called attention to the dissimilarity in the size of the pupils that occurs in general paralysis. He regarded this as a lesion of mobility that was of special importance in doubtful cases. This symptom has been justly recognised as a valuable sign by all writers at the commencement of general paralysis. M. Roque finds, from the observation of a large number of cases, that in a great number of unilateral diseases the pupil of the affected side is dilated. According to Baillarger, the difference in size is only perceptible when both pupils are dilated; when they are contracted, no difference is perceptible; it is due, therefore, not to paralysis of the dilated pupil, but to unusual contraction of the other, which remains contracted when the patient is turned from the light. Hence it appears that in general paralysis the pupils contract unequally. On the other hand, in unilateral affections of the thorax and abdomen or of the extremities, the pupils dilate unequally, the inequality disappearing when they contract. In following out his observations, M. Roque rubbed a little belladonna ointment on the forehead of those children who were suffering from pneumonia and pleurisy, and then found that a greater dilatation of the pupil on the diseased side. than of that on the opposite side occurred. Considerable difficulty occurs in applying the ointment exactly to the middle line, but when this was accomplished properly, the pupil of the affected side dilated more than the opposite one. Electricity applied to the cilio-spinal region also affords a very good means of effecting the dilatation of the pupils, and of estimating which dilates most. That of the affected side will always be found to dilate most.