or other viscera, it is of singular efficacy, conjoined as may be indicated with mercurials or iodine and arsenic.

Dr. Sam. B. Woodward, late of Worcester Insane Asylum, reported a case of parabysma schirrosum by conium and iodine. Its value in cancer cannot be doubted. Nothing will soothe the torment of a cancerous ulcer more effectually than the judicious use of this article. Of its curative power, I cannot speak from experience. In dysmenorrhoea and amenorrhoea it is of essential service. I have frequently substituted in those cases the phosphate of iron or Vallet's mass for the sesquioxide as more efficient, especially in paramenia cessationis (or suppressed menstruation).

In chlorosis the formula above given has proved eminently successful, and seemed to meet all the indications involved in the treatment.

In ophthalmitis strumosa, conium and iodine are of singular utility and especially in the subacute stages. The cure will be greatly expedited by the local or topical application of the plant as before indicated.

In sparganosis puerperarum (the swelled leg of puerperal women) it is of great efficacy, both internally and locally employed.

In impotency and sterility, it certainly is not destitute of power. Without citing any new cases, it will be sufficient for our present purpose to say, that from some cause, the impression obtained within the circle of my own practice, that no married lady could take the red-syrup, as the preparation was commonly called, without the hazard of augmenting her cares, and it has been objected to on this very account. My testimony here, like that of Dr. Gallup when interrogated concerning the diuretic power of cleavers, is not directly positive; he said that "he had used it, and his patients generally made water afterwards." So I have certainly known conception to follow upon its use, after a long period of repose.

The catalogue above given, enumerating the diseases and conditions in which conium may be advantageously employed for the most part, is derived from personal observation and experience. I have drawn from memory alone, never having kept a record of cases. Other conditions might be called up and other diseases might be included if it were deemed necessary. But after all, gentlemen, you must yourselves first become familiar with the nature, power, and manner of operation and the best mode of administering the article, before you can discern its adaptation for the accomplishment of a particular end.

The knowledge which I have endeavored to impart you must first make your own. You cannot here trade long upon borrowed cap

ital. It is not your knowledge of the plant that is an acquisition to your skill, but your knowledge of the medicine derived from the plant, confirmed by your own experience, that alone renders it valuable to you. It is not the medicine that makes the physician, but it is the physician that makes the medicine, and makes it accomplish his purpose. An old well-tried rifle in the hand of an accomplished hunter is one thing; but it is quite another thing in the hand of a novice. It is the accuracy of the knowledge which a physician attains of the articles he employs that alone entitles him to consideration and distinction. This constitutes the true measure of his skill, and is all that is valuable in experience. For the lack of such knowledge-a knowledge that comprehended the powers of remedial agents—I have repeatedly seen old practitioners labor assiduously toward the accomplishment of a case, where the pathological condition of the patient was manifestly beyond the reach of the entire Materia Medica. The conclusion is self-evident and irresistible-that such an one has no experience; he has never yet learned the true limit of the powers of the agents he employs, like those described by the pen of inspiration-"always learning, yet never able to come to the knowledge of the truth."

REPORT OF THE NORTHAMPTON COUNTY MEDICAL SOCIETY.

IN presenting this report, it affords us pleasure to be able to say that our Society is gaining in favor with every meeting, especially with those physicians recently locating themselves in our county seat, whether by recent graduation or removal from the surrounding country, all of whom have within the past year enrolled themselves with us. The meetings of the Society have been held quarterly at the rooms of the Y. M. C. A., Easton.

In addition to these stated meetings, a section" has been formed, mainly of those physicians residing in our borough, for the purpose of holding more frequent conversational meetings in connection with a" Journal Exchange."

From conversations held with the members of the various townships, I have ascertained the existence of no remarkable epidemics; although most of the zymotics have occurred in isolated cases, or small local outbreaks. In this manner, and in my own town practice, I have knowledge of cases of scarlatina, rubeola, variola, varicella, typhoid fever, etc. etc. During the past winter, which with us has been unusually open and free from snow-fall, acute pulmonary affections have been uncommonly rare in both adults and children. Especially so was pneumonia, it being replaced by the catarrhal bronchitis to a great extent. Croup also, until the spring months had arrived, was rare. In my own practice, two cases of the pseudo-membranous variety proved fatal; although probably severe from the onset, medical aid was not sought until the disease was so well established as to defy the most energetic treatment by emetics, warm bath, inhalations of lime vapor, and particularly the use of lactic acid in the form of cold or hot spray. This latter agent I had almost learned to consider a specific, having had apparently very decided success from its employment in three cases in the spring of 1873: twenty drops of the ordinary concentrated lactic acid (now largely used by the pharmacists in the preparation of the various lacto-phosphatic solutions), diluted with f3iv water, thrown at one time into the larynx by means of the steam atomizing apparatus, or the ordinary hand-ball spray, repeating as often as

every hour, until breaking away of the pseudo-membrane was evident by the relief of dyspnea and softening of cough, when the interval was increased to two and then to four hours. In one case of sec

ondary croup consequent upon measles, its action was so evidently beneficial that the little patient (æt. 4 years) called for it whenever the laryngeal space became obstructed so as to interfere with his comfortable breathing.

A very interesting case of cardiac disease occurring as a sequence to measles (or more accurately following upon its retrocession), came under my care last June. Miss A. W., æt 9 years, after exposure, before the eruption had fully matured, was attacked with dyspnoea, requiring her to sleep in a sitting posture. This, when I was first recalled, was accompanied by rapid action of the heart. Pulse 128, with a soft systolic endocardial murmur. This a few days later was so masked by rude respiration, as to render it inaudible to the physician called by me in consultation; no medicine seemed to have any effect upon the frequency of pulse, the best specimens of digitalis being employed; and on their failure, digitaline granules of Quevenne & De Homolle, Paris, with the same ill success. Soon after the cardiac disorder appeared, the urine became scanty, and after œdema of lower limbs, ascites followed, which by July 22d was so considerable as to interfere with respiration. On consultation with several physicians, paracentesis was performed in the ordinary way, through the linea alba, the patient being fully anesthetized by Squibb's ether, with result of a very unsatisfactory flow, requir ing several hours, and frequent clearing of the canula by a long silver probe of some obstruction at first thought to be fibrinous coagula, but afterwards decided to be some membrane pushed before, but not penetrated by the trocar, acting as a valve to the canular aperture, and effectually preventing the efflux of the ascitic fluid. The fluid was intensely albuminous, of a gruel-like consistence, pale in color. Only 5 pints were obtained, when the wound was closed, leaving, however, the abdomen nearly as tense as before the operation. The following day I was summoned hastily to the residence of my patient, and found her sitting on a cane-seated chair, with a large basin beneath her, into which was flowing, plenorivo, from the aperture made by trocar, enough of the fluid contents of peritoneal cavity to make at least one gallon. This flow gradually lessened as the tension of the abdominal parietes was decreased, but continued at intervals until her death, four days after the operation. The pulse-rate continued the same up to date of death; consciousness was unimpaired to the end. The difficulty met with in case, as well as in another of ascites, was caused by large uterine

this

fibroma, when the tumor ball-valved the orifice of canula when introduced in the medial line to such an extent as to require pushing away by a probe in order to obtain free exit for this fluid, and ultimately to cause another point in latero to be selected, and even there when the last pints were passing, the sharp edges of canula evidently so wounded the delicate capillaries impinging against it, as to cause serious apprehension of concealed peritoneal hemorrhage (this phenomenon variously explained in translation).

I devised, as a precaution against a repetition of these impediments and annoyances, a modification of the operation for paracentesis, consisting in a partial return to the old method, in which a blunt silver catheter was used, after the puncture was made with a bistoury. I had Mr. Gemrig, of Philadelphia, make me a silver catheter, of the length and calibre of the ordinary instrument as found in pocket cases, which would fit easily but accurately within the canula, with no curvature at the tip, and pierced with three large fenestræ. To this, when in use, I adapted a collar or shoulder at the distance it was desired to have it project beyond the mouth of the canula, within the cavity of peritoneum, by wrapping tightly with a strip of adhesive plaster. To the free extremity of the catheter I attach a yard or more of very light rubber tubing, of a calibre fully as large as that of the instrument. In using this, the trocar and canula are inserted in the usual manner, the trocar withdrawn, and the catheter, prepared as directed, inserted as far as the collar will allow. This acts as a complete guard to the sharp edge of the canula, substituting for it a rounded extremity, with no free edges save those of the lateral fenestra, wherein a peritoneal fold is very unlikely to become entangled. By the use of this instrument, in large tappings of twelve to fifteen gallons, I have been able to completely drain the fluid away without the slightest tinging of blood. This induces me to think that the "sanguineous sweating" produced by sudden removal of support to the capillary vessels of abdominal peritoneum, as described in the article before mentioned, may have been caused, as in my own cases several times, by traumatism.

Dr. JUNKIN reports the following case of membranous enteritis, an affection well and fully described by Da Costa, in the American Journal of the Medical Sciences for October, 1871.

Mrs. A. B., æt. 51, American, housekeeper, married, nervous temperament. Her past history is briefly as follows: From childhood she has been healthy. Eight years ago the patient was seized with an acute attack of dysentery. Six years ago uterine troubles ap