The first case in which he (Dr. Thompson) had employed it, was one of sub-acute rheumatism in a delicate woman. She had all the usual symptoms of the disease, with an irritable but not inflamed heart. There was profuse perspiration. The disease, when he saw her, had existed for four days. He gave her half an ounce of lemon-juice, with a little henbane, in about an ounce of camphor mixture, every six hours. In forty-eight hours the pain was much relieved, and the fever abated, and in five days she was well. He had employed it in other cases connected with phthisis in the Hospital for Consumption. In some of these cases there were cavities in the lungs, and in these, lemon-jnice had been found of great service. He should be induced to try it in almost all cases of rheumatism, but not in true gout. In acute rheumatism, after bleeding, he should also employ it, of course in all cases paying attention to the primæ vix.

Dr. Bowie had tried mineral acids in rheumatic cases at the Consumption Hospital, but was obliged to leave them off. He never saw any benefit from them.

Mr. Shearly had used lemon-juice in gout and rheumatism with much benefit.

Dr. Downing was surprised that acids should be of service in rheumatism. He had always found them do harm; even lemonjuice was injurious. The French authors had lately been writing much in favor of alkaline remedies. They applied alkalies, such as the carbonate of soda, externally, with benefit.

Mr. Hird said, that notwithstanding the success of lemon-juice in rheumatism, he should still be inclined to follow out the old plan of treatment. Tonics were often advisable.

The President said that Dr. Rowland had informed him of a case of calculus in the bladder, in which all remedies failed in affording relief; under a course of lemon-juice the patient got quite well.

Dr. Wiltshire said that he objected to the treatment of cases of rheumatism merely on the chemical theory of altering the condition of the blood by chemical agents. The first indication was undoubtedly to correct any disorder of the liver and correlative orgins. After this he considered that lemon-juice might be employed. London Lancet.

MEDICO-CHIRURGICAL SOCIETY OF EDINBURGH. FEB. 7.-MR. SYME, PRESIDENT, IN THE CHAIR.

CHLOROFORM IN SOME OF THE MORE COMPLEX AND SERIOUS OPERATIONS OF SURGERY. By Dr. KEITH, Surgeon to the Royal Infirmary, Aberdeen, &c.-CHLOROFORM IN MIDWIFERY.

The meeting was very fully attended. After stating that anæs

thesia was generally adopted in the surgical practice of the hos pital, Dr. Keith proceeded to relate several cases of lithotomy and lithotrity, in which he had used it with perfect success. He also detailed at length the case of a man, aged sixty-seven, upon whom he had performed the high operation for the removal of two large stones from bladder, each of which weighed two ounces. The man did well for several days, but was at last seized with symptoms indicating peritonitis, and died. Dr. Keith had now performed lithotomy eighty-three times. In fourteen of these cases the stone weighed from two to four ounces; and of these fourteen, seven died. He believed that the mortality and danger of lithotomy increased in proportion as the weight of the stone extracted increased. Dr. Keith recommended the adoption of lithotomy for all stones weighing less than half an ounce; of lateral lithotomy for stones weighing less than two ounces; of the high operation in cases where the stone exceeded two ounces.

Mr. Syme said that in the valuable paper they had just heard, it was evident that Dr. Keith wished chiefly to inculcate two points in practice; first, the value of the high operation for extracting very large stones from the bladder; and second, the use of chloroform in the use of lithotrity. On the first point, he would only remark, that he differed in opinion from Dr. Keith, and was satisfied that the dangers attendant upon cutting into the bladder from above the pubis, were so great as to render the operation applicable to but very few cases. In regard to the second point insisted upon by Dr. Keith, he (Mr. Syme) did not think it advantagous to have the patient insensible during the operation of crushing the stonet An operator who had so very large an experience as Dr. Keith might find no difficulty in introducing and working a large lithrotrite, in the case of an anesthetic patient, but he believed that most surgeons would find the operation impeded and difficult on account of the anesthesia. Further, the operation of lithotrity, if well performed, did not cause any pain, and consequently the chloroform would not be required. He thought anesthesia useful in lithotomy, but not in lithotrity. Mr. Syme was anxious not to be misunderstood; he strongly advocated the use of chloroform in surgery generally. After it was proposed by Dr. Simpson, he used it in the first operation he had to perform in the hospital, and ever since then he had continued the practice. Further, he desired at this time to state to the Society, that he believed anesthesia not only saved patients operated on from pain, but also from shock, and all its effects. When Dr. Simpson first stated this as his opinion, he (Mr. Syme) strongly opposed it; but now he was convinced that Dr. Simpson was right in his opinion. Some recent cases-espe cially one in which he had amputated at the hip-joint-tended very strongly to impress this upon him. In that case, he did not believe the man would have survived had the operation been performed

without chloroform. As it was, he was cheerful and comfortable a few minutes after the operation, and never had the slightest bad symptom to interrupt his recovery.

Dr. Simpson remarked, that the Society could not but be gratified by the candid and honorable manner in which Mr. Syme had publicly stated his alteration of opinion. His opinion now was one established upon the basis of a very large experience, and was formed in the face of preconceived ideas, and this circumstance, as well as the very high standing of Mr. Syme, gave it all the more value. But although there was, now-a-days, no resistance offered on the part of the profession, in Edinburgh, to anaesthetic practice, and on all hands there was unanimity, yet such was far from being the case in other parts of the kingdom. A practitioner in London, (Mr. Gream,) who published a pamphlet against chloroform shortly af er it was introduced into practice, and in all likelihood before he had ever tried it, or seen it tried, had lately been circulating a letter among some of his medical friends, seeking for reports of any cases of death or casualty, or especially of cases where sexual excitement resutted from the use of chloroform. Dr. Simpson was anxious that these questions should be answered publicly in the Society; and he doubted not that he stated the experience of all, in saying that, in Edinburgh, chloroform, thougi constantly employed in surgical and obstetric practice for more than fifteen months, had never give rise to any casualty. Further, he had never seen, nor had he ever heard of any other person having seen, any manifestation of sexual excitement result from the exhibi ion of chloroform, and it had now been given here in many thousands of cases. The excitement, he was inclined to think, existed not in the individuals anesthetized, but was the result of impressions harbored in the minds of the practitioners, not in the minds of the chloroformed. An imperfect dose often gave rise to excitement, but never, as far as he and others had observed, to sexual excitement. After inhaling ether during her confinement in the Maternitè, one Parisian prostitute, under the care of Professor Dubois, stated that she had had lascivious dreams. But surely it was, to say the least, very unbecoming to say that most English ladies should have sexual dreams (like one French prostitute) when under the influence of chloroform, as Mr. Greim wished to prove. Such attempts as these to villify the practice of inducing anesthesia, were now urged too late to have any effect upon the progress of the practice.

Mr. Syme said that he had never witnessed any sexual excitement produced by the exhibition of chloroform, but that he and others had frequently heard patients in the operating theatre, swearing when excited by chloroform, and that, sometimes, in patients, whose friends had seldom or ever heard using such language. Possibly these improper expressions were only a true exhibition of the state of the patient's mind, and it was always stopped by throwing him

deeply asleep. At all events, he did not think it afforded the least ground for objecting to anesthesia in operation.

Dr. Robarts had used chloroform in upwards of 500 cases in dental surgery, and had never witnessed anything at all indicating sexual excitement.

Mr. Millar said, that notwithstanding the very high authority of Mr. Syme, he was forced to state that he agreed with Dr. Keith in the two points chiefly dwelt upon in his paper. He believed that, under all circumstances, the operation of lithotrity was attended with no inconsiderable suffering; the mere introduction of the lithotrite being seldom performed without pain, and even the drawing of a drop of blood. And he believed, that in the hands of an adroit and able operator, lithotrity would be as easily and safely accomplished with anesthesia as without it. The opinion that the high operation of lithotomy was to be preferred in cases of large stones, he thought well founded. He did not believe it possible to say, before operating, of what size a stone was; but whenever its dimensions were very large, he thought it should be extracted through the brim of the pelvis, and not through the outlet. The cursing and swearing of which Mr. Syme had spoken, he believed was to be laid rather to the blame of the person charged with administering the chloroform than to the patient inhaling it. If a large, overwhelming dose were given, and the patient hurried past the exciting stage, no improper language would be heard. The class of patients seen in an hospital would curse and swear when molested during the inhalation of chloroform in the theatre, as they would curse and swear when molested in the streets if they were tipsey with ardent spirits. That afternoon he had taken occasion to observe this very circumstance in the cases of two rough men brought into the hospital with accidents for operation. In neither case was a single improper word uttered. The one man had partial amputation of the hand performed upon him; the other had a dislocation of the thigh reduced. Under the complete influence of chloroform this was easily done: indeed, he had seldom experienced less difficulty in reducing a dislocation of the shoulder. He looked upon the use of chloroform in dislocations as one of its most beautiful applications, and that, were it but for this alone, surgery stood deeply indebted to Dr. Simpson for the introduction of the agent.

ON THE AIR TRACTOR, AS A SUBSTITUTE FOR THE MIDWIFERY FORCEPS. By Professor SIMPSON.

Dr. Simpson first pointed out the rude and unhappy plans pursued in cases of protracted labour with the head sunk into the pelvis, before the invention of the obstetric forceps. Upon all these plans the forceps was a great and signal improvement-one of the greatest ever effected in obstetric surgery. But sometimes, especially in incautious hands, they were apt to injure both mother and

child, passed high up as they were between the fœtal head and maternal passages. If we had any means of seizing the exposed portion of the scalp of the child, and could exercise traction by this hold, we might thus, in many cases, expedite the delivery. Dr. Simpson exhibited an air tractor possessed of such powers, and capable of easy application to the head of the child. After pointing out its construction, he showed its power to the Society by fixing a small one on the palm of his hand, and lifting an iron weight of twenty-eight pounds with it, without in the least detaching it. It was capable of bearing traction to the extent of forty or fifty pounds, without separating, and by increasing the size of the disc, its powers could be increased. With the forceps, the traction required rarely or never exceeded thirty pounds. He and others had used the tractor with facility and success in several cases of labor. It was safe, and free from all the dangers of the forceps, as far as regarded the mother, and did not hurt the infant. Some gentlemen had seen it applied to children several days old, and the children lifted about with it, without any cry or appearance of suffering on their part. Its more evident advantages over the forceps were the following:It was attended with far less danger in the application and working; no space was occupied by it; it produced no compression of the head in the wrong direction; it could be used to bring the head from an occipito-posterior to an occipito-anterior position, or, if necessary, to bring down the occiput or forehead; lastly, it was of small size, portable, and cheap.-London Lancet.

WESTMINSTER MEDICAL SOCIETY.

FEB. 3.-J. WEBSTER, M. D., F. R. S., PRESIDENT.

COD-LIVER OIL IN PHTHISIS AND SCROFULA.

A discussion took place, which had its origin in the fact of Mr. Wing having, at the previous meeting, brought down to the Society two cods' livers, with the view of getting some fellow of the Society to obtain the oil from them. He was induced to take this step in consequence of the great discrepancy of opinion which prevailed respecting the true character of genuine cod-liver oil. He was desirous to know, from practical experiment, what were the characters of the pure oil. Many fellows addressed the Society on the subject. The majority of the fellows stated that they had found the oil to possess a very marked effect in almost all cases of scrofula and phthisis. In the first class of cases it was not only given internally, with the effect of much improving the general health, but it was applied locally to scrofulous sores, with the most marked benefit. In phthisis it appeared to exert its influence at once by its nutritious properties. It checked perspiration and removed ema