a much more certain preparation than phosphuretted oil. The former strongly recommends the zinc phosphide in nervous affections, with excessive excretion of the phosphates and defective nutrition of the brain, in spinal irritation, hysteria, and in various forms of paralysis. He observes that it is in use in Ireland as an effective remedy in scrophulosis, and that in England it has been recommended in neuralgia, in paralysis agitans, in sciatica, in collapse, in typhus, and as a tonic in chronic diseases of the nervous system. As a tonic it may be given in doses of grain per diem; and as a stimulant, in somewhat larger quantities for a few days. When thus given it improves the appetite, accelerates the pulse, excites the nerves, and augments the urinary secretion. If the sexual functions are excited, the dose has been too large. (Bulletin Générale de Med. 24, 45.)

Mode of Action of Potassium Iodide.-Dr. Kämmerer explains the medicinal action of this salt by referring to its decomposition by the action of ozonised oxygen and by carbonic acid gas. In solutions of potassium iodide, ozone causes separation of free iodine; and when in dilute aqueous solution the pressure of carbonic acid gas breaks up the salt into hydrogen iodide (hydriodic acid) and potassium bicarbonate, but the free hydriodic acid is readily decomposed by free oxygen even when not ozonised into iodine and water. Now iodide of potassium, when introduced into the stomach, is absorbed directly into the blood. Here it meets with a large quantity of carbonic acid gas at a high pressure, and is decomposed into hydriodic acid and potassium bicarbonate, and the former is then immediately split up by the oxygen in the blood into free iodine and water. And even if the decomposition of the iodide by the carbonic acid. does not take place, the oxygen in the blood, which closely resembles ozone in its properties, is capable of setting the iodine free. This free iodine does not act upon the inorganic constituents of the blood, since, on the one hand, the bicarbonates are not decomposed by it, and, on the other, between potassium phosphate and iodine a reaction may take place, leading to the formation of an inferior oxide of iodine (subiodic acid), which last is reducible with extreme facility, and consequently effects rapid combustion of organic material, free iodine being at the same time set free, which again becomes converted into hydriodic acid, to undergo the same series of changes. The action of iodide of potassium in augmenting the temperature of the blood and causing emaciation, Dr. Kämmerer considers to be fully explained by the action of the drug in increasing the combustive operations in the blood. (Med. Chir. Rundschau, Jan. 1877.)

Toxic Action of Glycerine.-M. Dujardin-Beaumetz and Audijé found that chemically pure glycerine, injected subcu

taneously in divided doses to the amount of 8 grammes (3ii.) in the course of twenty-four hours into dogs proved fatal. The phenomena presented, which they term "glycerismus," are loud cries, restlessness, followed in the course of a few hours by dulness, hæmatemesis, hæmaturia, depression of temperature, difficulty in walking, somnolence, and diminution of the beats of the pulse and the movements of respiration. Section of such animals showed that the liver was hyperemic, that there were hæmorrhages in the intestinal mucous membrane and in the kidneys, and that the blood was black and the heart dilated. The authors point out that the results of their experiments indicate the necessity of care in the treatment of diabetes with glycerine. (Med. Chir. Rundschau, Jan. 1877.)

Physiological Action of Sanguinarina.-Dr. R. Meade Smith, of Philadelphia, has drawn the following conclusions of the physiological action of sanguinarina, from 153 experiments made with this alkaloid on cats, dogs, rabbits, frogs, guinea-pigs, pigeons, &c. 1. Sanguinarina destroys life through paralysis of the respiratory centre. 2. It causes clonic convulsions of spinal origin. 3. It has no other effect on either the motor or sensory nerves. 4. It causes marked adynamia and prostration from its depressing action on the spinal ganglia and muscles. 5. It decreases reflex excitability through irritation of Setschenow's centre, and by ultimate paralysis of the spinal ganglia, in large doses. 6. It produces in cats, dogs, and rabbits a fall of pulse and blood pressure, the fall of the latter being preceded by a temporary rise after the administration of proportionally small doses. 7. The fall of blood tension is caused by a paralysis of the vasomotor centre, and by paralysis of the heart itself, probably of its muscular structure. 8. The temporary rise in blood pressure is due to irritation of the vaso-motor centre, previous to its paralysis by small doses. 9. The reduction in the pulse is due to direct action of the poison on the heart, through paralysis of its motor power. 10. Sanguinarina has no action on the liver. 11. It causes marked salivation. 12. It slows the respiratory movement by prolonging the pause after expiration. 13. This reduction is caused by loss of tonus of the respiratory centre. 14. Small doses cause an irritation of the respiratory centre, and consequently an increase in the number of respiratory movements. 15. Applied locally, sanguinarina soon causes complete paralysis of striped muscular fibre. 16. It always causes dilatation of the pupil. 17. It is an emetic. 18. It always lowers the temperature. 19. When introduced into the circulation it diminishes muscular contractibility. (The American Journal of the Med. Sciences, Oct. 1876.)

Diagnosis of Aneurisms of the Aorta by the Laryngoscope. At the Medical Congress held in the autumn of last

year at Turin, Dr. Zawerthal, after detailing the various symptoms that accompany aortic manifestation, and dwelling on their little diagnostic value, called the attention of the meeting to the deductions that can be made in such cases from an inspection of the upper part of the respiratory passages by the aid of the laryngoscope. One of these signs, long known, consists in the paralysis of one or both vocal cords, consequent on pressure applied to the recurrent nerve, the other, recently discovered by Schrötter, and investigated by Zawerthal, consists in a rhythmical introflexion of the upper part of the trachea, readily perceptible under the laryngoscope. The reading of the paper gave rise to a very animated discussion. (Archives de Médecin, Jan. 1877.) Antihydropin.-Bogomolow has tried the effects in dropsical effusions of a domestic remedy much employed in Russia, namely, the Blatta orientalis, or cockroach, giving it to nine hospital patients. The patients were for the most part suffering from diffuse nephritis with vascular troubles, and were all highly dropsical. The beetles were administered in the form of powder, five to ten grains being given per diem in the form of tincture, forty drops being given, and in the form of beetle tea. The action was always similar; the renal secretion and perspiration increased, the dropsy rapidly disappeared, as did also albumen and morphological elements. The powder did not exert any stimulating action on the renal apparatus. Bogomolow obtained the active principle in a crystalline forin, and has given it the name of antihydropin. (Petersburg Med. Wochenschrift, No. 31, 1876.)

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Treatment of Diphtheritis. Tenholt recommends mixture of salicylic acid and lime-water, containing two parts of the former to two hundred of the latter, in the treatment of diphtheria. The solution may be applied with a brush, or as a gargle. In children, or where great difficulty is experienced in applying it, half a teaspoonful may be given with a little milk every half-hour as a drink. Averbeck recommends that the patient should be well nourished, that no attempts should be made to remove the diphtheritic slough, since every wound effects a new inoculation, and every half-hour blows into the throat some flores sulphuris non depuratæ, with the addition of salicylic acid. If the swelling is great, and the insufflation cannot be accomplished, he applies warm water dressings, on Priessnitz's plan, to the neck, washes the mucous membrane with carbonic acid or salicylic acid and water, and administers quinine internally. (Allg. Med. Central. Zeit. 1876, p. 397, and Wiener med. Wochens. No. 38, 1876.)

Intra-buccal Elastic Ligature for the Removal of Lingual Tumours. Dr. E. Delens refers to the frequency of

epithelioma of the tongue, and the liability there is to hæmorrhage when the tumour is removed by the knife, which can only be restrained by the application of the actual cautery. He considers that neither the ecraseur nor the galvano-caustic method quite come up to the expectations that were formed of them, serious hæmorrhage having not unfrequently followed their employment. Billroth's plan of making a section through the skin, parallel to the border of the lower jaw, into the cavity of the mouth through which the tongue is drawn, he considers to be quite unpractical, since of nine cases thus treated Billroth lost four. Dr. Delens suggests instead that an elastic ligature should be passed round a part or the whole of the tongue, the thread being tightly drawn from the very first. It offers the advantages, he maintains, of absence of hæmorrhage and of the occurrence of consecutive glossitis; the swelling of the distal part of the tongue is in fact very slight. Moreover the pain, which is undoubtedly acute at first, rapidly subsides, and, if the ligature have been drawn tight enough, disappears in the course of a few hours. The mode in which the final knot is made is of importance, and he describes a special manoeuvre, the ends being passed through the substance of the tongue, by which any slipping is prevented. He prefers an elastic thread having a diameter of 2 to 3 millimeters. When properly applied ulceration quickly commences, and the constricted portion sloughs off in the course of the tenth day. The mouth requires to be frequently washed out with solutions of chlorate of potash, which has remarkable power in deodorising putrifying fluids. Alimentation, sometimes difficult, must be carefully attended to; speech should be interdicted; cicatrisation takes place readily. (Archives de Médecine, Jan. 1877.)

Treatment of Otorrhoea.-In a resumé of recent progress in otology, by Dr. J. Orme Green, he observes that Paulsen claims to have met with excellent results in the treatment of otorrhoea, uncomplicated with caries or large polypi, by means of a mixture of carbolic acid and olive oil, in the proportion of one part of the former to ten of the latter. He has found it much more effective than astringents or other methods which he has tried, and the combination of the acid with the oil was much better than the acid with water. His method of application is to cleanse the ear thoroughly by cotton or a probe, avoiding syringing unless absolutely necessary, and then, dipping a tampon of cotton in the solution, to apply it to the secreting surface, and there leave it till the next day, when the same process should be repeated. In this way he has succeeded in relieving obstinate otorrhoea, even when complicated with small granulations. Politzer gives the results of his experience with

caustic solutions of nitrate of silver, and recommends the employment of one part of the salt to ten or eight of water. All secretion should first be removed from the middle ear by inflation, either with the Politzer bag or the catheter, and the meatus should then be thoroughly syringed out; the meatus must then be carefully dried by pledgets of lint or, cotton, in order that the solution may come into contact with the diseased mucous membrane. For cauterising the middle ear, from ten to fifteen drops of the solution should be poured into the ear, with the head inclined in the opposite direction; if the membrana tympani be largely perforated the fluid readily enters the middle ear, but if the perforation be small, it is necessary to inflate the tympanum; the pain is slight. Schwartze combines with strong solutions of nitrate of silver the use of powdered alum. (Boston Med. and Surg. Journal, vol. xcv., No. 20.)

Means of Arresting Epileptic Attacks.-M. Nothnagel gives the case of a workman subject to attacks of epilepsy, in whom each fit was preceded by an aura, occurring usually from a quarter of an hour to half an hour before the fit. The aura was characterised by a peculiar sensation of constriction, the seat and point of departure of which was the epigastrium. The sensation seemed to rise in the throat, and to compel the patient to breathe deeply and rapidly. Then it seemed to descend, and after recurring several times, finally affected the head, which was turned to the right, when the patient immediately became insensible. He had discovered for himself that on putting a quantity of salt into his mouth, as soon as the aura commenced, he could ward off the attack; a sensation of burning was experienced in the oesophagus, and the affection re-descended; a teaspoonful was insufficient; a handful was required. BrownSéquard arrested, it is well known, attacks of epilepsy in his epileptic Guinea pigs by turning their heads briskly to the side of the body opposite to that of the medullary lesion; and it would appear that a strong peripheric stimulus will serve the same purpose, as sharp pinching of the skin in the epileptic zone or elsewhere, or the application of a tight ligature to the fingers. In such cases the effect is probably due to a simple reflex inhibitory influence. Prof. L. Meyer, remarking on these cases, states that several years ago, in fact as long ago as 1855, Prof. Nothnagel observed that sulphate of quinine administered a certain time before an epileptic attack was very effective in preventing its occurrence, and in these days, when intravenous or subcutaneous injection can be so readily employed, this means would appear to be worthy of further investigation. The quantity administered by Prof. Nothnagel was from fifteen to forty-five grains. (Berlin klin. Wochenschrift, Nos. 41 and 46, 1876.)