1852.] M. DEVILLIERS on the Treatment of Syphilis in Pregnancy.

203

efrcumscribed spot of the semi-transparent tissue of the iris, which has become deprived of its pigmentary matter-a fissure in the uvea. This theory explains: 1st. Why the musca are placed near the visual axis, but always on one side of it; 2nd. It explains the fact of their disappearance in obscure light, and their especial distinctness in a bright one, which induces the contraction of the pupil, and the enlargement of the aperture in the uvea; 3rd. Also their varied form, according to the different action of light upon the eye, and the effect of this upon the size of the fissure; 4th. It explains their appearance after sudden movement of the eyes upwards, which is always accompanied by a contractile oscillation of the iris, as also their diminution or disappearance as the pupil enlarges.

If this theory be sound, the musca ought to disappear when the pupil is dilated by belladonna; and M. Tavignot declares that his experiments have convinced him that they do disappear in proportion as artificial mydriasis is thus produced, and that they return again with the returning motions of the iris. It is to be borne in mind that these remarks are referrible only to essential musca volitantes; M. Tavignot intending to show hereafter, that in the sympathetic form (as in glaucoma) an altered condition of the texture of the iris explains the appearance, and adds confirmation to the above view.

Artificial dilatation of the pupil enables us to decide whether we have to do with muscæ volitantes, prop erly so called, or with the spots known as scotomata, which are found in partial cpacities of the cornea, and In incipient cataract; for while the musca volitantes disappear on the production of the mydriasis, the scotomata persist, and even become more distinct.-Gaz. des Hop., 1851, No. 127.

On the Combination of Lithotomy and Lithotrity in the case of large Calculus. By M. PETREquin. SINCE the introduction of lithotrity, lithotomy has become a far less common operation, and presents a much smaller proportion of successful cases, inasmuch as the most favourable ones are selected for the new operation. A surgeon will in future have some difficulty in bringing forward such a statistical account as that of M. Viricel, of Lyons, who, during 1806-12, operated upon 109 patients, and lost only 9, having 53

consecutive recoveries.

Among the dangers of lithotomy, the voluminous size of the stone stands foremost, so that when this has proved excessive, various authors have recommended the operation to be left unfinished. The older surgeons attacked these calculi by various forms of crushing forceps, all of these being of a most gigantic size. The moderns have more turned their attention to the improvement of the operative procedures; but in spite of any direction or extent that may be given to the incision, there are calculi too large to be removed by the perinæum withim punity, notwithstanding the dilatability of the prostate and the elasticity of the neck. Too large incisions also favour the infiltration of urine.

To meet such cases, M. Petrequin adopts a combination of lithotomy with lithotrity. He does not mean that cystotomy should be resorted to after lithotrity has failed, for fruitless attempts to crush the stone only add to the danger of subsequent cutting. Simple lithotomy should be confined to cases in which it is best calculated to succeed-viz., calculi capable of removal by a moderate perineal incision; and when the calculus is too voluminous we should call in the aid of lithotrity to reduce its size. Two cases are related in which this combination was attended by a happy issue, notwithstanding the presence of numerous serious complications.-Bull. de Therap., tom. xli. p. 442."

MIDWIFERY, &c.

On the Treatment of Syphilis in Pregnant Women. By M. DEVILLIERS.

THE following are the conclusions with which M. Devilliers terminates a memoir upon this subject -1. A pregnant woman usually supports mercurial treatment pretty well during the first half of pregnancy, and even from the first week.-2. Any injurious effects that may occur during this period, seem principally to depend upon a want of tolerance in the digestive organs, and consequent nervous irritability.-3. The foetus is more sensitive to the effects of syphilis, and to the action of specific remedies, in proportion as it ap proaches the perfection necessary for extra-uterine life.-4. In the application of treatment, the following circumstances in relation to the progress of syphilitic disease in pregnant women should be borne in mindviz. (a.) The condition of conception may excite the external manifestation of symptoms which, for a greater or less period, had remained dormant. (b.) The symptoms frequently exhibit oscillations during pregnancy, and have an especial tendency to re-appear about the sixth, seventh, or eighth month. (c.) They generally disappear spontaneously, and rather quickly after delivery.-5. Palliatives for primary symptoms In the early months are useless, and a radical treatment should at once be resorted to. It is still more urgent to treat without delay any secondary or tertiary symptoms that may be pesent.-6. Active treatment undertaken or recommenced towards the latter part of pregnancy-i. e., the period when abortion from syphilis is most likely to occur-requires greater precautions to be observed than during the early period.7. When the treatment during the first half of pregnancy has not been completely interrupted, or has been so only for a short time, its resumption on the re-appearance of symptoms during the latter period exposes both mother and child to less chance of accidents.-8. Treatment should not be discontinued too quickly after the disappearance of the symptoms, but persevered with in very small doses as long as possible.-9. The treatment seems to be well borne both by mother and child at all periods of gestation, in proportion to the complicated and aggravated condition of the syphilitic accidents.-10. The syphilitic symptoms, whether primary or secondary, which are manifested during the latter weeks of pregnancy, require general as well as local treatment. The child is then more amenable to treatment, if this be required after birth.11. We must not wait too long after delivery, to commence or resume treatment, deceived by the decrease of the symptoms so common at that period. If the child, suckled by the mother, exhibits any mark of syphilis, we must not wait later than the eighth or tenth day.-12. In the early period of pregnancy, internal mercurial treatment is often ill borne. This is less frequently the case in the middle and later periods. In the former, inunction should be resorted to.

M. Gibert, commenting upon the above essay, likewise says that the ill effects which several practitioners have observed to result from the administration of mercury in syphilitic women, have arisen from their giv ing it internally. It frequently excites vomiting and colics in the fourth and fifth months; and mercurial

frictions are infinitely preferable. Abortion from syphilis ordinarily occurs after the fourth or fifth month; whence, if treatment is to be preventive, it must be commenced early.—Bull. de l'Acad., tom. xvii. p. 77; Bull. de Therap. tom. xli. p. 439.

On the Reproduction of Lactation after a lengthened Intermission. By M. GUBLER and Dr. BALLOU. Two very interesting communications have appeared at the same time from different quarters, showing that when suckling has been suspended, even for months, it may, in the great majority of cases, be resumed by a little perseverance on the part of the mother. The first of these is from M. Gubler, who gives an account of M. Trousseau's experience in this matter. That able practitioner is in the habit of advising that children whom disease or accident have kept away from the breast, and who are suffering in consequence, should be reapplied at periods when this is usually deemed useless. Cases are referred to in which the breast had not been taken for two, four, or even nine months, and wherein the resumption of suckling was usually attended with little difficulty, or at all events only temporary difficulty, and followed by the best effects.--L' Union Medicale, 1852, No. 7.

The other communication is a paper read by Dr. Ballou at the Rhode Island Medical Society, in which he mentions, that he was led by physiological considerations to expect that the secretion of milk might be re-excited without much difficulty, even after a lengthened suspension of it; this being chiefly dependent upon "the stimulus which the child exerts upon the mamma in its efforts to obtain nourishment from them, connected perhaps with the mental desires of the mother to foster and nourish her offspring. Accordingly he states that in several cases where a temporary malady had checked the secretion of milk, and a suspension of the function of lactation had necessarily ensued, in cases where there was no return of the secretion after recovery, he ordered the child to be applied to the breasts, two, three, or more times daily, with the uniform result of a renewed secretion of milk. In other cases, where the mother was suffering from debility, and it was evident that the system could not sustain itself under so great a tax upon its powers, Dr. Ballou has directed the removal of the child for a season, and the drying-up (to use the common phrase) of the milk, until the restorative powers of the system, with the assistance of appropriate means, should produce a return of health and vigour. After the recovery of health, he has advised the re-application of the child to the breasts; when it has in a few days uniformly obtained the usual supply of nutriment, in some instances to its own great benefit. In no case, Dr. Ballou assures us, have his expectations been disappointed.American Jour. of Med. Sci, Jan. 1852.

On the Jaundice of Infants. By M. DUCLOS.

ALTHOUGH this frequent affection of early infancy does not, in the great majority of instances, present any danger, it occasionally gives rise to important occurrences, and indeed, when complicated with other affections, may sometimes prove fatal.

Besides the yellow colour, the icterus of infants may be attended with fever, somnolence, tension of the belly, and colic, with constipation or diarrhoea. Its causes may be ranged under five different heads, which it is of importance to distinguish. 1. Retention of the meconium is the most frequent of all. If it be not evacuated within twenty-six hours, colicky pains are set up, and the skin becomes yellow. The colostrum is in this case the best purgative. When the child cannot or will not suck, a teaspoonful or two of the syrup of rhubarb, chicory, and peach-flowers, equal parts, may be given. When, after the meconium has been passed, a considerable degree of tympanitis remains, together with what is called "windy colic," preventing sleep, M. Duclos administers small doses of rhubarb and calcined magnesia.-2. The next in frequency is spasm of the digestive organs. The child suffers from cardialgia and colic, is in a state of fever, is constantly trying to suck, and has few or greenish stools. Sometimes convulsions occur. Purging and vomiting aggravate in place of relieving the condition. As retained meconium is usually the origin and cause of the symptoms, that must first be obviated, and then recourse had to emollient baths, mild anti-spasmodics, linseed poultices, friction with camphorated oil, and mild lavements. If the milk is too old, the nurse should be changed; and when an anodyne is required to relieve the violent colic, a little lettuce-water should be added to some sugared water. This description of medicine, however, requires care, and opiates in any form are inadmissible. Narcotism, which induced death in one child and was nearly fatal in another, was brought on by a clyster containing ten drops of laudanum.-3. Engorgement of the liver is another cause, and one especially acting after compression of that organ by the uterine contraction in foot and breech presentations. When this condition is present, purging the child is not sufficient. It must be kept warm, and its skin rubbed with hot flannel; with gentleness, however, lest erysipelas be induced. When the skin is rough and hot, emollient tepid baths are useful adjuvants.-4. Bad nourishment is a frequent cause of icterus, the milk disagreeing with the child, or improper food being given to it when brought up by hand.-5. Cold and hu midity: young infants are very susceptible to changes of temperature-too great heat or cold being alike injurious to them; but as regards the present affection, cold is especially mischievous.-Revue Med. Chir, tom. x. p. 350.

On the Increase of Weight observed in Infants consequent upon Suckling. By M. Guillot. M. GUILLOT observes, that although many attempts have been made to determine the quality of the milk furnished to infants, no information exists as to the quantity they really take or require; and he proceeds to give an account of some experiments he has made upon the subject, by weighing the child every morning prior to and after suckling, and multiplying the weight so obtained by the number of times that suckling is repeated in the 24 hours. At present he only publishes some of the rough results, to call attention to the subject and induce co-operation in the investigation.

We may observe here, that it seems to us by no means safe to infer that the child sucks the same amount of milk each time that it is applied; while the number of times M. Guillot says that the children are applied in the 24 hours (from 25 to 30) seems truly enormous.]

In the examples given, the quantity of milk estimated to be taken by children from 2 days to 40 days old, in the 24 hours, varied from less than 1 kilogramme (nearly 32 oz Apoth. weight) to nearly 4 kilogrammes, the quantity usually fluctuating between 1 and 2. The rapidity with which even slight ailments

were attended with a diminution of weight was remarkable. One child gained 270 gramme in 17 days; and a loss of weight of 90 grammes, consequent on slight erythema of the nates, was repaired, and 260 grammes added to the original weight, six days after the erythema had ceased. This oscillation of weight, consequent upon disease apparently slight, is one of the most remarkable circumstances ascertained. A child weighing 3904 grammes on admission, at the age of 30 days, increased to 4258 grammes in 12 days; and its nurse was calculated to have furnished it during a month with milk equal in weight to that of her own body. The examples upon which these statements have been founded, were hospital children; and M. Guillot believes that the more robust infants of private life will be found to require at the end of the first month more than 2 kilogrammes of milk daily, their weight increasing more than 50 grammes per diem. When the child from illness is unable to swallow or digest, its weight rapidly diminishes; and death may always be expected when this diminution continues progressive. Examples are given in which the child lost 500 grammes in 5 days, and decreased to 1700 or even 1500 grammes in weight. This diminution is observed in infants that are brought in with sclerema, and cannot suck; but the most rapid diminution of weight takes place under the influence of diarrhoea. The weight of a child in good health, and with a good nurse, should regularly increase day by day. It decreases, on the contrary, sometimes several days prior to the outbreak of diseases (as pneumonia or measles), and during their continuance. It again resumes its regularity of increase when these have disappeared. On the other hand, a remarkable increase of weight sometimes precedes diarrhoea, being due to accumulation of matters in the intestines. M. Guillot's general conclusion is, that an infant must be supplied with more than 1000 grammes of milk a day.-L'Union Medicale, No. 16.

MATERIA MEDICA AND THERAPEUTICS.

On the Employment of Manganese. By MM. PETREQUIN and BURIN.

In this paper M. Petrequin brings forward additional evidence of the greatly-increased efficacy which the combination of manganese with iron confers upon the latter metal. M. Burin has recently had a memoir which he presented to the Academy, upon the condition in which manganese exists in the blood, very favourably reported upon by M. Lecanu. According to M. Burin's analyses, 1000 grammes of blood are thus constituted as regards this substance :

M. Burin has furnished several formulæ for ferro-manganese salts, which are now obtainable in Paris, and are as easily administered as is iron alone-their only drawback being their high price. This metal being as much a normal ingredient in the blood as is the iron, its administration is indicated in chlorosis and other cases, in which both substances are in deficient quantity; and M. Petrequin believes that the resistance which many of these cases offer to iron, and their frequent relapse, may be obviated by this addition, by the use of which also a smaller quantity of iron is made to suffice. He objects to the administration of this substance unaccompanied by the iron; and he regards the statement that sometimes the manganese, sometimes the iron, is deficient in quantity in the globules, as purely conjectural-the analysis showing thus far, that both substances are alike wanting. M. Petrequin has found these combined medicinal bodies especially useful in blood diseases, such as the chloro-anania after hæmorrhage, operations, metrorrhagia, &c. They are of remarkable efficacy in the chlorosis which appears about puberty, a malady which is far more common even among male adolescents than is supposed. It is also met with at the critical period of women, especially when passive hæmorrhage prevails. Its efficacy is also remarkable in the anæmic cachexia following prolonged intermittent fever, as also attendant upon prolonged suppuration, and on strumous and cancerous disease. In the disordered states of the circulation met with in the chloro-anæmia, which are sometimes mistaken for organic disease, the ferro-manganese preparations, combined with digitalis or other substances, are of great utility. The various neuroses of the digestive organs, which complicate the chlorotic state, are frequently relieved; and in the disorders of the nervous system, from various descriptions of excesses, they are found highly useful.-Bull. de Therap, tom. xlii. pp. 193-206.

Turpentine Embrocation in Ague.

THE following embrocation is recommended by M. Debout as being highly efficacious as a substitute for quinine, and especially for the poorer classes: Essential oil of turpentine, 100; chloroform, 10; or laudanum, 4. It is to be rubbed along the spine twice a day, during the apyrexia, taking care that one of the frictions should take place an hour or two prior to the expected paroxysm.-Bull. de Therap., tom. xlii. P. 15-1.

Employment of Oxygenated Water in Asphyxia. By M. RUSPINI.

In a recent series of experiments upon the effect exerted by various gaseous bodies upon the contractiliy of the heart of the frog, MM. Polli and Broglia have especially drawn the attention of practitioners to the stimulating effect of oxygen gas in asphyxia; and to the feasibility of employing injections of oxygenated water when the respiratory organs can no longer perform their functions. M. Ruspini, of Bergamo, recently in part carried out these views in treating a case of asphyxia from charcoal vapour, in which a slight degree of animal heat constituted the only remaining sign of life. He caused some oxygen to be disengaged from a flask of oxygenated water, and this having been respired, and a little of the oxygenated water poured down the throat, animation became speedily restored.-Jour. de Chim. Med., No. 4, p. 276.

On Matico in Diarrhea. By M. MODONINI.

M. MODONINI States that he has employed this substance in about 120 cases, and usually with good and speedy effect, in various species of intestinal discharges, and especially in atonic diarrhoea. It is given at the Bologna Hospital in doses of from 18grs. to 3j. per diem, no inconvenience, save a little nauseau or diarrhoea, ever being caused, and this being capaple of removal, either by diminishing the dose, or temporarily suspending the remedy. In the most favourable cases, an impression is made upon the disease by three or four doses; and it is quite relieved in from three to six days. The medicine should, however, be continued awhile longer, in order to prevent relapse. In those diarrhoeas in which, owing to the existence of visceral changes, or the presence of a general dyscrasis, the return of the diarrhoea is inevitable, the matico is still an invaluable remedy, owing to the rapidity of its astringent action, which enables us to suspend the exhausing discharges and obtain time for the employment of any other means which the nature of the case may indicate.-Bulletino delle Scienze Med., vol. xx. p. 63.

On the Mode of Administration of lodine. By M. DEVERGIE.

M. DEVERGIE administers the substance as an "antilymphatic," in the following manner:-Porphyrized unoxidized iron filings, 40 centigrammes; iodine, 1 gramme, 65 to 80 Centig.; water, 8 grammes; simple syrup, 500 grammes. The iron and iodine are triturated in a mortar, the water being added drop by drop, and then incorporated with the syrup. When it is desired to add the iodide of potassium, 6 or 8 grammes are previously dissolved in the smallest possible quantity of water, and incorporated with the iron and iodine before the syrup is added. A tablespoonful of this syrup is given in a bitter tisane (that of hops, prepared according to the Paris Codex, being the best), night and morning.-Gaz. des Hopitaux, No. 22

On the Treatment of Chilblains. By M. TROUSseau.

M. TROUSSEAU washes all parts affected with chilblains, three times a-day, with the following lotion :Borax, 50 parts; water, 500. Four tablespoonfuls are added to a quart of water. He also prescribes, both for the prevention and removal of chilblains, the following lotion, to be used night and morning :-Sal ammoniac, 20 parts; water, 40; proof spirit, 10. When ulceration has occurred, he prescribes one of the following formula:-Tannin, 10 parts; water, 500. Or, Ext. Rhatany, 10 parts; quince mucilage, q.8. This is mixed up as a soft electuary, with which the parts are smeared; and the application is also an excellent one for the cra cked lips which occur in the winter.-L'Union Med., No. 35.

On the Preventive Power of Belladonna in Scarlatina. Dy Dr. PORcher.

In this paper Dr. Porcher presents his readers with an analysis of the various opinions which have been published upon this subject since they were summed up in the 2nd volume of Bayle's Bibliotheque de Therapeutique. This survey has necessitated the examination of some hundreds of volumes, and Dr. Porcher be lieves that a dispassionate consideration of the subject necessarily leads to a conclusion decidedly in favour of the prophylactic power of this substance. "However some may consider the evidence of a negative character, and therefore unworthy of confidence, yet from its cumulation, from the careful way in which some observers conducted their inquiries, and from the possibility of failure being owing to the use of an inferior or badly-prepared drug, we cannot but conceive that to discard it as utterly indecisive would be indulging a spirit of irrational incredulity, leading to the rejection of any amount of merely presumptive proof."Charleston Medical Journal, vol. vi. p. 453.

On Disguising the Taste of Quinine. By M. PIOrry.

A PIECE of chocolate should be half masticated, and retained between the cheeks and the teeth. The quinine draught is to be rapidly swallowed; and then the mastication of the chocolate is to be completed, so that it may be swallowed also. The taste of the quinine is thus hardly perceived.-Bull. de l'Academie, tom. xvii. p. 329.

On the Effects of Camphor on the Teeth. By M. STANISLAUS MARTIN.

SOME time since a warm discussion was carried on by our weekly contemporaries as to the effect exerted by camphor dentifrices. In France, for some time past, camphor, under the patronage of M. Raspail, has be come the popular specific for all bodily ills. There are numerous persons who are in the habit of daily administering to themselves a camphor lavement, rubbing-in camphor ointments, washing the mouth with the spirit, snuffing the powder, inhaling the fumes, or chewing the substance. Its effect is supposed to be preservative from colds in winter, and from miasmata and epidemic influences in summer. One of the results of this folly is the frequent production of pains of the jaw, and a carious state of the teeth. M. Martin has for several months kept teeth in contact with camphor in powder, and finds that the essential oil completely penetrates them, and diminishes their hardness. If we mix phosphate of lime and powdered camphor, the water which is added is loaded, in the course of some months, with calcareous matter, which is certainly due to a chemical action between these two bodies.-Bull. de Ther. tom. xl. p. 456.

On the Rapid Cure of Itch. By MM. HARDY and Devergie.

M. HARDY states, that by the modification which he has introduced into the mode of treating the itch at St. Louis, he is now enabled to definitively cure a patient in two hours, so that it is in contemplation to treat all patients suffering under this disease as out-patients. The entire body is first thoroughly rubbed for half an hour with soft soap, which has the effect of breaking up some of the furrows in which the acari are lodged. A tepid bath is next employed for one hour, in order to soften the epidermis, the patient continuing to wash

himself well while in it. Finally, the patients rub each other thoroughly for half an hour over the entire surface with the sulphur ointment (lard 8 parts, sulphur 2, subc. potass 1), and the itch is cured. The various secondary eruptions, formerly confounded with the itch, may require several days for their dispersion, by means of simple baths. In 4 only out of 400 cases so treated, have relapses occurred, and 144 cases out of 145 occurring in June were so cured.

In this way the disease spreads by contagion much less than heretofore, when the patients had to wait until they could obtain admission into the hospital.-In a recent paper, however, M. Devergie expresses an opinion that this rapid cure of a disease which has often been long persistent, is a practice not to be followed, as being dangerous to present or future health. In certain forms of itch the secretion is abundant, and when the disease has been mistaken, this may increase, so as to form a kind of purulent emunctory not to be at once destroyed with impunity. It is probable that some of the internal abscesses, which have been observed in cases of this disease, have arisen from its repercussion; and certainly in no other form of pustular eruption would the practitioner thus act The itching or pruritus which is produced is not entirely an indifferent matter, and the habit of nocturnal scratching must not be suddenly suppressed. Even when pedicular disease or prurigo is suddenly arrested, dangerous pulmonary congestion sometimes occurs, requiring active rubefacients, although here little or no secretion has been suppressed. A single gentle friction suffices to destroy the contagious property, and it is best to complete the cure by repeating such for five or dx days, than to run the risk, by too violent friction with very strong ointments, of producing the too sudden repression, or of exciting various forms of eczematous or lichenoid eruptions, which are sometimes more difficult to cure than the original disease, especially among the working classes, who are so apt to neglect the condition of their skin -Union Med., 1851,No. 95 ; Bulletin de Therapeutique, tom. xli. p. 385.

On the Treatment of Intermittent Fever by Salt.

THE employment of so cheap a substance as salt, as a succedaneum for quinine, has of late attracted much attention in France, several practitioners having stated that they had derived great advantage from its use. M. Piorry has instituted several trials at his hospital, and has delivered a very favourable report to the Academie de Médecine, basing his approval, however, chiefly on the alleged fact, that the salt produces an immediate diminution in the size of the enlarged spleen, which he considers as the essential cause of the febrile paroxysm. He believes it of use even in some cases where quinine fails, and in others in combination with quinine. A great obstacle to its employment is the utter repugnance the patients manifest to it in the large doses (ten or fifteen grammes) in which it is required, and the difficulty of retaining it in the stomach. His recommendation that its use should be adopted in charitable establishments, and in the army, was warmly opposed in the Académie, by MM. Grisolle and Levy. The former declared, the trials upon which this had been based were most unsatisfactory, as the diagnosis had been made from the condition of the spleen, not the symptoms of the disease. The cases, too, had been treated as soon as admitted; whereas Chomel long since showed that the altered hygienic condition of patients admitted, alone sufficed to cure a large proportion without any medicine at all. M. Levy declared that M. Piorry's doctrine of the dependence of intermittent fever on enlargement of the spleen, met with no favour among the medical officers of the army, familiar with the disease in Algeria, Corsica, and Rome, where it prevailed endemically. They were well aware that the organ always became engorged and diseased, as a consequence of the affection. In these localities, too, where the engorged and diseased state of the viscera and the cachexia consequent on repeated attacks rolases had to be combated, medicines which proved successful amongst the simple intermit tents of Paris had far less success; and a much smaller proportion of cases were cured by quinine itself than in the capital. For treating these more complicated cases, he considers the cinchona itself, and especially the vinum cinchone, to be far preferable to quinine-it being at once a febrifuge and a tonic, while the quinine and its substitutes act as mere anti-periodics.-Bulletin de l'Acad., tom. xvii. p.p. 315 & 390 ; Gaz. Med. 1852, No. 8.

On the Medicinal Uses of Urate of Ammonia. By Dr. BAUER.

In

FIVE years' observation has convinced Dr. Bauer that this is a most valuable medicine in chronic cutaneous diseases and in tubercular diseasees of the lung. An ointment containing one scruple to the ounce, is applied by a pencil to the eruption night and morning, the cure being effected in from one to three weeks tubercular disease the ointment is rubbed-in alternately night and morning on the back and front of the chest. No inflammatory complication should be present during its employment.

In reference to this substance it is interesting to observe, that in Colombia, South America, where lepra prevails so extensively, the benefit derived from the external and internal use of guano has beer. placed be yond all doubt; and Dr. Lallemand has found it of great utility in the treatment of morphe in the Brazils. The urate of ammonia, which is found in this subtance in great abundance, is probably the chief medicinal agent.-Buchner's Repert., No. 19, p. 86.

FORENSIC MEDICINE AND MEDICAL STATISTICS.

On Poisoning by Sulphate of Iron. By M. ORFILA.

M. ORFILA observes, that prior to Smith's and his own experiments in 1815, the salts of iron were supposed to be almost innocuous; and when these experiments proved their poisonous effects on dogs, the point was still regarded by many as undecided as respects man, although M. Orfila has fully demonstrated, that all substances which prove poisonous to the dog, do so also to man. Several trials before the French tribunals have of late years decided the actual occurrence of such poisoning. In the most recent one, M. Orfila has been consulted in consequence of the incompetency of the provincial experts; and he has drawn up an interesting report of the case, embracing some incidental questions. The present case was that of a child aged fifteen months, who died after purging and vomiting a black fluid. On opening the body ten days after burial, the stomach was filled with a greenish fluid, and the vessels of the lungs and brain were gorged with black blood. M. Orfila detected sulphate of iron in notable quantities in the portions of the abdomi