off. No hooklets were found in it. After the operation the boy vomited several times, had slight fever, and an eruption of urticaria; but no tenderness of the abdomen. The urine was found to contain albumen, due to the presence of pus. July 15th, the abdomen was enlarging again. When the boy was made to sit up in bed he complained of pain in the loins, and four of the lumbar spines were found to be prominent, and the skin over them reddened. They were very painful on pressure. The tumor was aspirated again, and thirty-one and a half ounces of a greenish opalescent fluid were withdrawn, which, in the latter stage of the operation, was flaky and apparently purulent. After standing, the fluid deposited two ounces of pus. Under the microscope, pus-cells and the heads of numerous echinococci armed with hooklets were detected. The boy vomited again several times after the operation, but no urticaria followed the second puncture. On July 25th and 26th small cysts with hooklets were found in the urinary sediment. From this time the patient became gradually better. In November he was discharged from the hospital and kept under observation for some months. When last seen, he was quite well, the abdomen being perfectly normal and the urine free from pus and albumen.

EPITHELIAL CANCER TREATED BY DILUTED SOLUTION OF SODA. —Prof. Busch.—(Allgemeine Wiener Mediz. Zeitung). The commencement of the epithelial cancer of the face is in many cases a simple proliferation of the epithelial cells of the external layers. Under certain circumstances the pressure of the external horny layer will cause atrophy of the papillæ underneath. In other cases, particularly in old age and in cases of constant irritation (chimney-sweeps), no epidermis is formed; the rete mucosum is exposed, and we have an ulcus rodens. If this hornlike layer of epidermal cells which obstructs the road for the succeeding cell formations is removed in a gentle manner, we can prevent the further growth of the cancers. This can

be done by washing off the epidermoidal masses with a diluted solution of soda. Therefore, in the first stages of the facial and labial cancers, a cure can be accomplished by alkaline lotions.

This treatment is also sometimes successful in cancers that have existed for some time; and after the excision of a cancer a relapse can frequently be prevented by washing the scar with alkaline solutions.

Paget had observed that cancer may follow an excessive accumulation of the epithelial cells on the surface of the mamma. Langenbeck also observed that he had seen very favorable results from the application of Emser thermal waters to cancerous ulcerations.

ON THE REGENERATIVE PROPERTIES OF THE PERIOSTEUM AND ITS PRACTICAL APPLICATION.-Von Langenbeck. (Centralblatt fur Chirurgie No. 22.)-When the periosteum of a bone has been removed, to a considerable extent it will be replaced by new periosteum, without necrosis of the bone occurring. If this new periosteum is deprived of its bone, the bone will also be replaced. This has been proven by experiments of Bernhard Heine.

Experience teaches Langenbeck that this re-produced periosteum possesses great vitality; and that for plastic operations the integument, that has become adherent to the bone, when removed with its periosteum, is of great value.

The author relates the history of two cases in which, through accident, the skulls were injured so that large openings were left in the cranial cavities. In these cases, L. used the integuments of the scars, with its periosteum, to cover and close the openings, and obtained the best results. He also related the case of a person who had lost a portion of the hard palate through syphilitic ulcerations. By using the tissue of the scars left, he succeeded in a partial restoration of the bone, while he had failed by using portions of the regular muco-periosteal lining or integument from unaffected portions of the mouth. Gangrene of these cicatricial flaps only occurred in anaemic individuals that should have had a previous tonic treatment.

III. PRACTICAL MEDICINE.

TREATMENT OF NEURALGIA BY HYPODERMIC INJECTIONS OF NITRATE OF SILVER.-Le Dentu. (La France Médic, 1877.) -The author has recently reported to the Society of Clinical Medicine several cases treated successfully by the method first suggested by a M. Luton.

A young woman suffered for four months from a neuralgia of the radial nerve which had been treated in all possible ways. In view of this want of success, Le Dentu decided to inject subcutaneously in the cellulo-fatty tissue found in the middle third of the external face of the arm, seven drops of a solution of nitrate of silver (1 to 4). The result was that an intense pain succeeded immediately the pain of the neuralgia, the latter not once recurring after the moment in which the injection was made. On that and the succeeding days a very painful swelling invaded the arm and the upper part of the fore-arm with an oedematous and subsequently phlegmonous tumefaction at the site of the puncture. After nine or ten days an abundant sero-pus flowed from the latter, but the suppuration gradually diminished and the cure was finally complete. Two months afterward it was ascertained that the relief was absolute.

Having had since then no opportunity to make further trial in obstinate neuralgias of Luton's method, the author concluded to employ it in painful affections of another kind. A man who had been castrated on the right side and had been relieved by the operation, was tuberculous and suffered from frequent hæmaturia, violent pain in the glans penis and in the lower part of the belly and lumbar region, the permanent pain being aggravated during and immediately after micturition, but never entirely ceasing. The lumbar and testicular pain disappeared under the influence of punctate cauterizations, but the hypogastric neuralgia persisted. Le Dentu then made a subcutaneous injection into the hypogastric region, of four drops of a solution of the nitrate of silver (1 part to 5). Very intense pain resulted with phlegmon and suppuration on the fourth day. Quite thick pus escaped after an opening was

made. But in nine days the patient was quite satisfied with the result, for although he still suffered from the pain during micturition, it had completely disappeared during the interval.

Again in a patient with scapulalgia, where punctate canterization had effected no result, an injection of four drops of the same solution into the connective tissue immediately in front of the painful region, was followed by intense pain; local suppuration and an abscess on the fifth day. But on the second day after the injection the deep seated pain was completely relieved, and movement of the limb was readily ef fected.

Le Dentu concludes with the remark that he has always seen a small abscess result from the operation, but that by opening the former prematurely-say on the fourth or fifth day, this inconvenience would be much lessened.

GASTRIC AND INTESTINAL GASES, WITH FLATULENT DYSPEPSIA. -Leven. (L'Union Méd., Oct. 11, 1877.) The following are the author's conclusions:

Alimentary substances do not seem to produce gas; that which is found in the digestive tube is derived from external air, blood or fecal matter. The gases produced in flatulent dyspepsia are not due to the decomposition of alimentary substances, but are derived from the three sources mentioned above. They are kept in continual motion by the pathological contraction of the muscular fibres of the intestine; they are continually renewed; their production may be incessant, as well in an individual who is fasting, as in one who is nourished.

This symptom, production of gas, signifies, therefore, an intestinal irritation which is always consecutive to a prior gastric dyspepsia.

The course of the disease and the treatment requisite to cure it, confirm these clinical facts.

There is no necessity for seeking a medication to relieve the gas, and, as for the powders, such as charcoal, which are said to absorb it, they actually have no such effect, as the author has proved by experiment. A block of charcoal, it is true, may absorb gas, but as soon as it is reduced to powder it loses its absorptive power.

A NEW INVESTIGATION OF THE ROLE OF THE ALKALIES IN THE ANIMAL ECONOMY.-Mialhe. (L'Union Méd., Oct. 11, 1877.) The fact of the indispensable necessity of the constant presence of the alkalies in the animal economy was first established, in 1824, by Chevreul; but he attributed this to a need of the caustic alkalies, while it should be properly referred to the alkaline bicarbonates.

In the present state of science we are authorized to say that the influence of the alkalies upon organic matters, which renders possible their oxydation in the sphere of the animal economy, can no longer be questioned. This the author has demonstrated in several memoirs on digestion, assimilation and organic or vital oxydation. Inorganic bodies certainly exist in the organs of animals, and these exhibit an indisputable activity; such are iron, phosphate of lime and the alkaline bicarbonates.

Resting upon these facts, Mialhe endeavors to solve the question: Can the alkaline bicarbonates, when administered in large doses, give rise to a special cachexia, designated as the alkaline cachexia? This question he answers in the negative, and concludes with some general considerations relative to the administration of the alkalies.

What is proposed by the administration of the sodic bicarbonated waters? The end desired is the introduction into the blood of a proportion of the bicarbonate of soda, sufficient to sensibly modify the intimate composition of the albuminoid materials with which the alkaline element enters into combination; and, as a result, the stimulation of the phenomena of organic or vital oxydation, as well as that of endosmosis and exosmosis, with a view to modify the nature of secretions, etc.

What, now, is the proportion of the bicarbonate of soda which it is proper to introduce into the economy, in order to produce this result?

It is impossible to give a categorical answer to this question, because the proportion of the alkaline base which exists in the animal economy, whether in the state of the bicarbonate or of the albuminate, is far from being always the same, not only in the animals of the two great classes, the herbivora and the carnivora, but also in animals of the same species. Thus the