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logy. The key, Dr. Kirsten thinks, is to be found in the most recent researches of Bernard. This physiologist has shown that the formation of sugar in the liver is especially apparent when the abdominal circulation is increased, and the temperature rises. The biliary matter chiefly turns into sugar at a temperature of 40° Cent. No time was more favourable for this transformation than gestation, when the abdominal circulation and temperature are always raised to the necessary point for sugar-formation: whenee we ought always to expect glycosuria in pregnant women. But as this is not the case, we are obliged to conelude that the greater quantity of sugar produced at this period is wanted for the nourishment of the child, so that it cannot be excreted. It would be interesting, with a view to the verification of this hypothesis, to examine the urine of women whose children may die, as quickly as possible after their death. During the puerperal week the abdommal circulation is lessened, and the afflux of ulood takes place towards the periphery, as is evideneed by the milksccrction and sweats. This condition would not be favourable to the formation of sugar.

IV. Labour.

1. Cate of Uneonscious Delivery. By George Smith, M.D. (Indian Annals of Medical Scienee. April, 1857.)

2. Retarded Deliveries, probably Caused by Psychical Influenees. By Robert Annan. (Edinburgh Medical Journal^ Feb. 1857.)

3. On a Neu> Obstetric Instrument. Bv Dr. Lubwio Contato. (Wochenbl . der k. k. Gcsellssch. d. Aerate zu Wieu. March, 1857)

4. On Tympanitis Uteri. By Dr. Alois Vausnta. (Wochenbl . d. k. k. GescfJsch. d. Aerate zu Wien. Feb. 1857.)

5. On Tympanitis Uteri. By Dr. Mcclintock. (Communicated to the Reporter. Sept. 1857.)

1. Dr. Smith's case of uneonscious delivery is interesting both in a physiological and medico-legal point of view.

Mrs. S was daily expecting her confinement. On the 24th April, 1856,

I was sent for suddenly, and on reaching the house, found the child born, and lying under the bed-clothes, close to the body of its mother. The cord was entire, and the placenta within the vagina. The delivery had taken place suddenly. During the night preceding her delivery, this lady had felt quite well. She rose several times to attend to her sick child. About half-past five A.m. she walked from her house to the bungalow in which she was confined. When she reached the bungalow, she lay down upon the cot, and experieneed a very slight sensation, as if her bowels were about to be relieved—a feeling as if something had touched her body followed, and caused her to ask the ayah to lift the bed-clothes, when, to the surprise and alarm of both, the child was

found entirely extruded. Mrs. S was awake, and yet so little was her

notice attracted by her feelings, that the delivery took place uneonsciously. This was her second child. The first was born with the usual pains, after a labour extending over six hours. The child—a female—was a little undersized, but not much.

2. Mr. Annan's cases of retarded delivery serve to illustrate the vexed question of the duration of gestation. A woman, after passing the danger of premature labour, suffered shipwreck, went through excessive physical exertion and exposure and mental anxiety, in attempting to save a child; she nevertheless had no pains, and was delivered 332 days after the cessation of the last menstruation. Mr. A next relates two cases of retarded delivery following psychical exaltation. In one, a woman aged thirty-four, mother of several children, expected, according to her reckoning, labour on the 5th June, 1851 ; at the end of the seventh month, having attended the exhibition of a mesmerist, she returned home so unwell and excited that she had to seek medical advice, especially dreading premature labour. There were no pains, and in a few days she had recovered. The period of delivery passed over, and on the 20th July, quite six weeks later, she was delivered of a child weighing ten pounds four ounces, by the forceps. The size of the placenta corresponded to that of the child. Her former children had not much exceeded seven pounds in weight. In the second case, a woman aged forty-four was delivered in the beginning of October, 1840, whilst she had had her last menstrual period at the end of December. Shortly before she had heard of the severe labour of an acquaintance, and had been much excited in consequence. Here also uterine contractions first appeared long after the calculated time—namely, on the 20th November; and the woman was delivered on the following day of a dead child, with the forceps. It weighed nine pounds eight ounces. Another case is related, in which no obvious cause of retardation was present. A woman, aged twenty-six, who had aborted three times, which was also threatened in her last, pregnancy, was delivered of a child weighing ten pounds eleven ounces, on the 15th February, 1857. Her last period was observed on the 1st April, 1856, so that about 327 davs had expired. [The Reporter has also observed cases where excessive weight of the child corresponded with apparent protraction of gestation.]

3. The new instrument devised by Dr. Contato is said to be adapted to decapitating the foetus in utero. The inventor calls it the Dccapitator. It is difficult to give a perfect idea of its construction without the aid of figures. The general principle, however, may be said to be the same as that of the guillotine. It consists of two parts. One part terminates in a curved halfring, the inner or concave border of which is grooved, for the reception of a knife, which, fixed to the other half of the instrument, is made to slide along the stem of the first half. The objections to the instrument seem to be, 1st, to discover the cases in which the operation of decapitation is desirable; 2nd, to apply the instrument. The inventor gives no practical illustration to prove the working capacity of the instrument.

4. Dr. Valenta's case exhibits one form of a rare affection—tympanitis of the uterus. A woman, aged forty-three, who had borne twelve children, was brought to the Obstetric Clinic at Vienna, on the loth October, 1850, from a country district distant two hours' journey. Labour had set in on the 13th. The midwife, not feeling any presenting part, sent for the surgeon, who ruptured the membranes ; upon this the left hand came down. On the 14th, attempts were made to extract the child by the sharp hook; this failing, another surgeon being called, replaced the arm, and prescribed ergot. On the following day she was taken to Vienna. The uterus was then found unusually but equally distended, so that it was impossible to discern any part of the child; the fundus reached to the xyphoid process, and was very painful; percussion in the circumference of the uterus gave a remarkably clear-sounding tympanitic resonance. The child's left hand, bare of epithelium, was felt in the vagina. No sign of rupture was discovered. Great febrile irritation, shivering, pulse ICO, bilious vomiting. Exploration of the position of the child revealed the cause of the distension of the womb and the resonance, for suddenly a rush of stinking gas escaped from the uterus, followed by loosening of the distension. Delivery by turning was effected. It was found that the brain had escaped through the opening made previously by the perforator.

The patient sank on the following day under symptoms of acute peritonitis. Autopsy revealed adhesions of the right Fallopian tube and ovary to nterus and psoas muscle; the left tube distended with gas; the uterus itself very flabby, easily moveable, its anterior surface pale-red and smooth, its posterior surface bluish-red and covered with flocculent deposits; the substanee of the uterus in the highest degree lacerable; the inner surface covered by a loose, knotty, delicate, dirty-brown, very foul-smelling mass. s

The conelusion of Dr. Valenta was that the tympanitis was due to the evolution of putrid gas from the decomposition of the child, the gas being prevented from escaping by the closure of the mouth of the womb by the child. [It is probable that early delivery by turning on the 13th would have obviated this process, and averted the fatal result.—Reporter.]

'5. The case of tympanitis uteri, with which the Reporter has been favoured by Dr. McClintock, is especially illustrative in juxtaposition with the preceding. The case occurred in the Dublin Lying-in Hospital, during the present year. A primipara passtd nine hours in tie second stage of labour. At 8 P.m. the os was mostly dilated; the membranes broken; pulse 112; tongue getting furred. The symptoms indicated the desirability of completing delivery. At 9 A.m. the irritation had inereased; pulse 120; complains of constant pains in uterus; head partially in pelvis; no tumour on head; foetal heart inaudible. The entire uterine tumour anteriorly is quite remnant on percussion. When finger was passed up between head and pubis, a discharge of foetid air came away from the uterus. Craniotomy; no blood came from head. Rigor at 6-80 P.m.; and another on the second day; tongue white, dry, rough; belly tympanitic; no abdominal pain or tenderness. Opium, quinine, and wine admimstered. Sloughing of vagina followed—the result partly of pressure during protracted labour, and subsequent poisoning of the blood from absorption of foul air. The child was putrid.

It seems a necessary condition for the production of tympanitis uteri, that the child should be dead and the membranes broken, so that air may enter the uterus, and give rise to the ordinary putrefactive process.


Guano in obstinate Skin Disease/.—Recamier (Gazette Medicale de Paris, No. 4, 1857), in the latter portion of his life, prescribed baths of guano iu the treatment of some skin diseases; and a Belgian practitioner, M. Van der Abcelc, has recorded six cases where this plan has been adopted with success. Three were cases of ecthyma and three of eczema. The baths employed contained 500 grammes of guano in solution.

Valerianate of Atropia.—M. Hichea (L'Union Medicale, January, 1857), who has for many years devoted great attention to the therapeutical virtues of the Solanaecae, publishes a case in which the valerianate of atropia proved to be more efficacious in asthma than stramonium, and some other previous remedies. He employs the valerianate in the form of pills, as beiug most convenient and most certain, and the dose is from half a milligramme to two milligrammes. In asthma, he advises the discontinuanee of the remedy, and its renewed use alternately, every week in persons under twenty-five years of age, and every fortnight in persons above that age.

Nitrate of Silver in Ozama.—The remedy proposed by M. Galligioli (Raceoglitore Meaico di Fano, 1857) is the fused mtrate of silver, but employed in a different manner to that adopted by others. He prefers making a pommade by mixing nitrate of silver with hog's lard, and introducing it into the nasal fossae.

Strychnia and the Woorara Poison.—Dr. Vulpian (L'Union Medicale, Jan., 1857) has made some experiments on animals with these poisons, in consequence of a suggestion by Dr. Thibeaud that they are antagonistic in their actions, and might therefore be employed as antidotes to each other. The result, however, is that Dr. Vulpian does not consider woorara an antidote to strychnia, and that it is equally inefficacious, and may be mischievous, in the treatment of tetanus.

Poisoning by Caustic AmmoniaEfficacy of Chlorate of Potash.—Dr Fonssagrioes, of Cherbourg (L'Union Medicale, January, 1857), relates a case in which a sailor swallowed a large quantity of caustic ammonia with a suicidal intention. Vinegar and water were administered in abundance, but an oedematous and inflammatory condition of the glottis was induced, requiring the application of leeches; and afterwards an enormous quantity of limpid mucus ■was discharged from the mouth. The chlorate of potash was employed to alleviate this symptom, in the dose of two grammes a day, and in five days the salivation was almost entirely suspended.

Hydrocotgle Asiatica.—M. Fournier (Bulletin General de Th^rapeutique, March, 1857), in analysing this plant, has found that one hundred parts afford fifteen of ash. These ashes consist of a soluble portion and of a part insoluble in water. The soluble salts are the chlorides, iodides, and sulphates of magnesium, sodium and potassium. The carbonates are almost completely wanting. The author prefers the hydro-alcoholic extract, prepared in a vacuum, as the best form for medical use.

Tannin-draught in Chronic Bronchitis.—Dr. Berthel (Bulletin General de Th6rapeutique, March, 1857) recommends the following draught in bronchitis of long duration:—20 centigrammes of tannin, 5 centigrammes of belladonna, 15 centigrammes of hemlock, 90 grammes of infusion of senna, 50 grammes of fennel water, and 50 grammes of syrup of mallow. A tablespoonful to be taken every two hours.

Achillea Millefolium as an Emmenagogue.—Dr. Ronzier Joly (Bulletin General de Therapeutiqne, March, 1857) relates some cases which proved the efficacy of this plant as an emmenagogue. He was first induced to try its powers in restoring the menstrual flux by the case of a young girl of eighteen, who had tried the usual means of cure without effect, and in whom the administration of a strong infusion of the millefolium induced the menses in half an hour. Upon inquiry, Dr. Joly ascertained that, in a village some miles distant from his residence, the women were in the constant habit of using the plant for the same purpose.

Balsam of Copaiba in Psoriasis.—M. Hardy (Bulletin General de Therapeutique, March, 1857), Physician of the Hopital St. Louis, commences the treatment of psoriasis by giving about three grammes of balsam of copaiba, then, during the treatment, the dose is raised to four and six grammes: the copaiba is administered in the morning, fasting, and the interval of meals. This treatment is continued for a certain time—at least a month, and sometimes more. But M. Hardy seldom confines his treatment to the employment of copaiba, although he has employed it alone, successfully, in certain cases. In general he associates it with local measures.

Bran-Bread in Diabetes.—Mr. Camplin (Medical Times, May 2, 1857) gives the following directions for the preparation of bran-bread. Take a sufficient 40-xx. -18

quantity of wheat bran, boil it in two successive waters for ten minutes, each time straining it through a sieve, then wash it well with cold water, on the sieve, until the water runs off perfectly clear: squeeze the bran in a cloth as dry as you can, then spread it thinly on a dish, and place it in a slow oven: if put in at night, let it remain until morning, when, if perfectly dry and crisp, it will be fit for grinding. The bran thus prepared must be ground in a fine mill, and sifted through a wire sieve of sufficient fineness to require the use of a brush to pass it through: that which does not pass through at first must be ground and sifted again, until the whole is soft and fine. Take of this bran powder, 3 ounees Troy; 3 fresh eggs; 1| ounee of butter; rather less than nalf-a-pint of milk; mix the eggs with part of the milk, and warm the butter with the other portion: then stir the whole well together, adding a little nutmeg and ginger, or any other agreeable spice. Immediately before putting in the oven, stir in first 35 grains of scsquicarbonate of soda, and then 3 drachms of dilute hydrochloric acid. The loaf thus prepared should be baked in a basin (previously well buttered) for about an hour, or rather more. Biscuits may be prepared as above, omitting the soda and hydrochloric acid, and part of the milk, and making them of proper consistenee for moulding into shape.


Mr. Dempster on (he Causes of Marsh Poison in India.
(To the Editor of the British and Foreign Medico-Chirnrgieal Review.)

Sie,—In the October number of the 'Medico-Chirurgical Review, for 1855, you did me the favour to notice the report of a committee (of which I was the sole medical member) on certain sanitary questions connected with canals and canal irrigation in India, and you coneluded that notice with the following remarks:—

"We cannot couclude this notice of the valuable inquiry carried out by Mr. Dempster and Major (now Colonel) Baker, without expressing a hope that we may again hear from them, and that the above summary of the results arrived at by those gentlemen may excite others to institute similar investigations."

In answer to this invitation, I now beg to lay before you some very interesting and important additional facts relating to the subject, which have recently been brought to my knowledge, and wuich I hope will be found worthy to be communicated to the profession in England and the colonies, through the medium of your journal.

In autumn last, a fever of an unusually virulent character committed great havoc in a " Zilla" or district about twelve miles distant from the city of Allyghur, in the upper provinees of the Bengal Presideney. It was of much importanee to ascertam, if possible, what was the real nature of this disease. Was it an epidemic, arising from occult atmospheric or other influences which can neither be foreseen nor counteracted by any means yet at our disposal? Or was it a pure endemic, depending on local, and perhaps easily remediable, causes? These were obviously questions of much practical import to the inhabitants of the district under consideration.

The fever was said by some to be contagious, but mention was also made of a "nulla" (the Korrum) having overflowed its banks, and it was determined to apply my spleen test for malarious fever. The examinations were commeneed nine miles from the "nulla," and carefully continued up to it. It was found that there had been an unusual amount of fever all over the district, and

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