of coagulable lymph, and of purulent exudations in bad constitutions, and many other similar facts in pathology that might be enumerated, which are as yet unexplained.

[New York Med. Jour.

On Physical Diagnosis of Fevers.--By E. A. PARKES, M. D.-There are two diseases not unlike typhoid, to which I wish now to direct your attention, and which may be mistaken, and are mistaken for typhoid--one is pyæmia, so called, but it is quite untrue there is any pus in the blood; the other is acute tuberculosis. In pyæmia we have its positive indications absent, such as inflamed joints, diseased veins, etc.; we have septic materials in the blood in pyæmia, and a vital change perhaps in that fluid, but you cannot well mistake it for typhoid fever. There is another disease, however, which has been lately quite mistaken for typhoid--this is acute tuberculosis, in which, more or less, every organ in the body becomes studded with tubercles, and known in England and the continent as "military tubercles," in the intestines, heart, lungs, and in the female even in the uterus and pelvic viscera. It is a disease common in younger patients. The disease, however, is extremely rapid, in three or four weeks usually coming to an end. It is attended with febrile symptoms, furred dry tongue; the symptoms, in fact, all like as possible of typhoid. It runs parallel, so to speak, with typhoid, but is not typhoid. Acute tuberculosis is often mistaken for typhoid, but the rose-spots are absent. In these cases the best observers will make mistakes. These tubercular deposits are miliary; they are uniform over the lung. We have no opportunity of comparing diseases in one part of the lung with another; no stethoscopic indications, in fact, but those of bronchitis. Again, in this disease of acute tuberculosis, the head symptoms are always most intense, from deposit, in the shape of acute meningitis; the latter produced by deposit of tubercle. It is, in fact, something quite out of the common way to find bad headache in typhoid; torpor is more common; and according as the disease advances, as a general rule, head symptoms are found to go away. You will find, also, if you study these cases in the wards of the hospital for yourself, that the pupils are dilated in meningitis, and that the special senses of hearing, taste, smell, etc., are all more or less affected. Deafness, for instance, is common; and, as I have just said, you will have most intense headache. Again, in one disease the abdominal symptoms will seize your attention; in the other, the head or chest symptoms. Diarrhoea is not so frequent in one; while in the other it is almost specific. In acute tuberculosis, you will not find the intestinal glands red

and inflamed; in the other affection we are speaking of, it is very characteristic after death. The typhoid stools are liquid, yellow, or brown, containing albumen, and coloring matter of bile; this singular substance rendered mahogany color by nitric acid. In hospital I would advise you to familiarize yourselves with all these circumstances.

To sum up the whole matter, then, you will find that in these two diseases, confounded by superficial observers, we have a prominence, at the bedside, of head symptoms in one, and abdominal symptoms in the other. We have symptoms also of pyrexia in one. We may have "typhoid pneumonia," using these words now in a different sense, "typhoid" as an adjective; with all the other differential signs already indicated. Then bad influenza, with capillary bronchitis, may also be mistaken for one of these diseases, purulent meningitis and a disease lately described in Ireland "cerebro-spinal meningitis."-Dublin Med. Press.--Ibid.

On the Therapeutical Value of Plyulism.--By M. PASSOT, of Lyons. In a memoir published in the Gaz. de Médicale de Lyon, for June, 1854, Dr. Passot lays down the following propositions:-

1. There are cases in which mercurial salivation ought to be induced, no matter how grave may be its results.

2. Mercurial salivation has a double action; a revulsive action, far more energetic than that of the blister, and a spoliative action, or impoverishment of the blood.

3. Some individuals are insusceptible, and others extremely liable to ptyalism.

4. The surest method of inducing salivation, consists in the simultaneous use of calomel and mercurial inunctions.

5. It is doubtful whether salivation ever exerts specific influence.

6. Syphilis is not only curable without ptyalism, but it appears that the syphilitic manifestations cease to be affected specifically by mercury as soon as this phenomenon is manifested.

7. Ptyalism is especially indicated in peritonitis, metroperitonitis, simple meningitis, corneitis, retinitis, amaurosis by congestion, in obstinate orchitis and ovaritis, and certain chronic engorgements unconnected with degeneration of tissue.

8. Mercurial stomatitis is to be treated by rubbing the gums with powdered alum (Velpeau); by painting the mucous membrane with chlorohydric acid (Ricord), or with a concentrated solution of nitrate of silver (Bouchacourt). Repeated

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purgatives, and the application of Saturnine lotions to the neck, are useful as adjuvants.

9. As soon as the state of the mouth will permit, the patient should be allowed a good diet and the use of ferruginous medicines to combat the debility induced by the mercurial intoxication.- Virginia Med. and Surg. Jour.

Female Physicians.-A lady suffers from a headache, the female physician is called in, and prescribes a new bonnet. Another female doctor finds her patient dying to go to the seaside. The husband might as well write and take the lodgings instantly; the doctor will be sure to order it.

Prescriptions will be made up of new dresses, bonnets, boxes at the opera, broughams, a party now and then, increased allowances for housekeeping, trips out of town, and the thousand and one other little whims which ladies are constantly dying" to be indulged in.

The doctors will declare late hours on the husband's part most dangerous; order them, as they prize their health, to leave off dining at their clubs; tell them that latch keys are undermining his constitution; that cold mutton once a week on washing days is highly beneficial to the system; and as for smoking in the drawing-room, or bringing nien home unexpectedly to dinner-they would not answer for their lives a single day unless they give up such unwholesome practices.

Women have got already sufficient means of mastering us. Let them have doctors of their own sex to assist them, and the husband's case will be indeed a hard one.

"Perhaps, after all, there is no great absurdity in the notion of female physicians. All physicians except those who practice gratuitously, may be designated by the word female spelt with another e; and there are not a few of whom that is all that can be said. If the head of woman is not calculated for the formation of a diagnosis, she can at least shake it in a difficult case, as effectually as a man can; and having a softer and more musical voice than the masculine, she is better qualified than the most men are for that large part of medical practice which consists in whispering comfort to invalids." [Punch.-Ibid.

Croton Oil.-Dr. STARK (Lancet, Sept.) recommends croton oil one drop with colocynth every hour, "till a full evacuation of bilious matter is procured." Diluted sulphuric acid, with a little sulphurous acid, is sometimes simultaneously employed to check the vomiting.

Upon the Nature of Sausage Poison.--The following data are extracted from a notice in Schmidt's Jahrbuch (78, 4) of Prof. Julius Schlossberger's essay upon the Sausage Poison. (Vierordt's Arch. xi. 5).

"The first notice of poisoning by sausage, dates from the year 1735. Most of the cases known up to the opening of the present century are found in the Journals of Autenrieth, Kopp, Hufeland, Henke, Rust, Horn, in the works of J. Kerner, and in scattered dissertations which Schlossberger particularly cites. The instances of poisoning by fish have been principally referred to abroad, by Christison, Lichtenstädt, Orfila, Chevallier and Duchesne.

Sausage poisoning is found, as is well known, to occur principally in Swabia; S. estimates the number of cases of sickness produced by sausages in Würtemberg, within the last fifty years, to be at least 400, and the number of deaths from the same cause at least 150. Isolated cases have also been observed in Baden, Bavaria, Hessia, Dessau, Prussia, Saxony, and two cases, not sufficiently confirmed, in France. The poisonings nearly always occur in the winter and spring months, the greatest number proportionately in the month of April, (two fifths of the whole,) that being the period where those that are eaten have been kept the longest; while in the warm weather, they pass so rapidly into actual putrefaction with the development of stinking gases, as to cause them to be rejected by persons with even the most blunted senses.

Blood and liver sausages are the only kinds in which the poison ever forms, which S. explains by the mode in which the country people are accustomed to prepare and preserve them. They are, for instance, principally prepared from the blood, brain, liver and similar parts, that are more liable than others to pass quickly into decomposition; are mixed with materials also that easily ferment, such as milk and wheat flour, while the boiling is often incomplete, or too long delayed in warm weather. The smoking also is often incomplete, either from defective smoke houses or from the diameter of the mass being too great, (in the so-called "blungen," or hog's stomach). In such preparations the stinking putrefaction may be kept off or delayed, but full play is permitted to another species of decomposition the more dangerous, because impossible to be detected by the senses. Besides, these badly smoked sausages are often kept tightly packed in close, confined places. This kind of sausage, moreover, is often prepared by unskilful country butchers, or by the peasants themselves, who, to prevent the intestines from bursting, often purposely commit great er

rors in boiling and in filling them; too often leave hollows that are filled with fluid, or suffer the sausage to be too greatly penetrated by the broth. All the kinds of blood and liver sausages are of considerably greater diameter than those made from meat, and consequently are more difficult to stuff tightly and to smoke thoroughly (especially in the central portions) than the latter; the poisonous decomposition proceeding evidently from the centre outwards. In place of the blood of swine, that of cattle and of goats is often in part substituted, together with the plucks of sheep. That poisonous properties should likewise be found in such sausages cannot surprise us, when we bear in mind the similarity in composition of the blood and tissues of all the higher animals. Neither spices nor salt, which are generally used in great amount by the country people, prevent the commencement of this species of putrefaction. The character of the intestine used (those of swine and cattle) can have no influence upon the development of the poison, beyond that which arises from imperfect cleansing, and from the too great diameter, rendering the stuffing and drying more difficult.

But few perciptible physical changes are exhibited in the poisonous sausage. They often contain in the interior spots like curds or soft cheese, and occasionally are of a crumbly, almost brittle consistence, that extends more and more towards the circumference. Frequently nothing peculiar is presented to the taste or smell; the odor is somewhat disagreeable resembling that of rancid fat. It is very probable that this odor is due to the formation of volatile fatty acids, since the neutral fats are always present in these sausages, under circumstances favorable to the decomposition of their fatty basis, the protein bodies present serving as ferments, or perhaps giving rise, by their own spontaneous decomposition, to these acids. The taste is described sometimes as sour, sometimes as bitter, or as rancid. A sausage examined by S. showed in its centre softened, curdy places; possessed an acid re-action, (free lactic acid) an odor resembling butyric or metacetonic acid, and developed, by the addition of weak potash, an ammoniacal and also an extremely disagreeable odor; hydrochloric acid produced therewith copious fumes. The intestine was mouldy; the peripherical layers of the sausage were of normal appearance and not of acid re-action. It is not, however, proved that these softened places are the seat of the poison, many poisonous sausages not possessing them, and it is decided that different portions of the same sausage proved injurious with one individual and harmless with others; and of various spoiled sausages, subjected to the same conditions, some produced symptoms of poisoning, whilst others did not.