When the disease affected the whole body, or when an artificial eczema had been induced by the improper application of local remedies before admission to the hospital; green soap, a variety of the ordinary soft soap, was applied. When hard patches remained on the nates, or other parts which are exposed to pressure, potash fomentations were employed (zi of caustic potash to 3xx of water). When the eruption was confined to the hands, hand baths of common sulphate were used, in the following manner: one drachm of common sulphate and one scruple of muriate of ammonia are dissolved in a little distilled water, which is then diluted till the whole amounts to six pints; a handful of bran is then thrown in, and the patient inserts his hands, rubbing them well together, when the bran facilitates the destruction of the pustules. These baths, used twice a-day, effected a rapid cure. When obstinate pustules or excoriations, arising from itch, occurred in other parts of the body, this solution was successfully used as a fomentation. Many of the new methods recently suggested in Germany, and strongly advocated by their respective authors were put to the test, but the results were not so satisfactory as could be wished. Of these methods, Wacherer's was the most successful. It consists in the inunction of oil of turpentine in the affected spots. The number of patients treated in this way was 68; and the average period of treatment till a cure was effected was four days and a half. They were all, however, simple, uncomplicated cases.

Pericarditis, with Effusion. Successfully Treated by Tapping and Injection of Iodine. Dr. ARAN has reported, in the Bulletin Therapeut a cass of pericarditis, treated by tapping and the injection of iodine. The patient was a man, æt. 23, of delicate constitution; the signs of pericardial effusion were well marked, the quantity being so great as to cause great oppression; a great variety of remedies had been tried in vain, and it was resolved to puncture the pericardium. The operation was performed with a capillary trocar, in the fifth intercostal space, two or three centimetres from the extreme limit of dullness. About twenty-six ounces of reddish serum were withdrawn, the fluid at first flowing per saltum. Great relief followed. An injection of distilled water and tincture of iodine, an ounce and a half of each, with fifteen grains of iodide of potassium, was then thrown into the cavity of the pericardium, and after a few moments withdrawn. No ill effects followed, and twelve days after the same operation was again performed owing to a reaccumulation of fluid. A dram of the iodide was this time used; air entered also, but the operation was successful, as the fluid did not again collect, to any considerable extent.

SURGERY.

Tracheotomy in Croup, By Dr. TROUSSEAU. - I am firmly decided, for my part, not to be discouraged, but to advocate tracheotomy with so much the more conviction, as the proportion of successful cases increase; and if that proportion remained, even as it was ten years ago, I would still proclaim the necessity of tracheotomy, and I would not

cease to uphold it as a duty-a duty as imperious for a surgeon as the ligature of the carotid artery, after a wound of that vessel, even if death followed the operation as often as the cure. Here are the results of my operations for tracheotomy, during the year 1854 :-I operated on nine children. Of these, two died, while seven were cured, and are now living in perfect health. Certainly, the proportion of cured is not always so great; still, if I make the sum total of the operations I have performed in the last four years, I find twenty-four operations, and fourteen cures, equivalent to more than half.

At the Hôpital des Enfans Malades, in the last five years, the proportion of cures has been nearly a quarter. Here are the official numbers, viz :

This result is considerable, if we remember the social condition of the children who are brought to the Hospital, the deplorable treatment they are subjected to, by "sagefemmes, quacks, etc.; in a word, those persons the poor generally consult in preference to doctors. We should bear in mind, too, the unfavorable condition of the Hospital, where the children operated upon are placed in the midst of the most varied and fatal contagion; so much so, that often, when the operation for tracheotomy is succeeding as well as could be desired, the scarlet fever, measles, small-pox, or whooping-cough, cause the most fearful complications.

I do not doubt that half the operations performed out of Hospital are successful, always provided tracheotomy takes place when the chances of cure are possible. This restriction is important; for, if the diphtheritic infection is thoroughly rooted in the system, if the skin, and particularly the cavities of the nose, are invaded by this special phlegmasia; if the quickness of the pulse, delirium, prostration, indicate a profound poison, and if the danger is rather in the general state, than in the local lesion of the larynx or of the trachea, certainly the operation should not be tried, for it is invariably fatal; when, however, the local lesion constitutes the principal danger of the disease, no matter at what degree asphyxia has arrived, even if the child has but a few moments to live, tracheotomy succeeds invariably, as well as though it had been tried three or four hours sooner. - Med. Times and Gaz.

Unreduced Dislocation of Hip treated by Extension. A case of dislocation of the hip, unreduced four months, which we saw under the care of Mr. Cock, at Guy's Hospital, deserves to be noted, as here the plan by manipulation with chloroform, originally mentioned in The Lancet, did not succeed in the reduction. A very good limb was subsequently obtained, however by the constant tension of a heavy weight and traction, so kept up after the violence, unavoidably used under the chloroform, that the new plastic matter, it is conceived, formed a new acetabular cavity over the site of the old one. In very old dislocations of this class, the experience at Guy's Hospital would seem to point to a partial or complete filling up of the old acetabulum, so that even though the surgeon might bring back the head of the bone to its normal position, as was done here once or twice, it will slip again over the rim, or perhaps towards the sacroischiatic notch, the articular cavity being unable to receive it. It was singular that after inhala-' tion of chloroform the foot, in place of being as usual in such cases inverted and shortened, had nearly regained its normal length, and was everted. Under these circumstances, Mr. Cock placed the leg on a straight splint, and subsequently, when the splint could not be borne, a weight and pulley, playing over the foot-board of the bed, served to keep up extension. For two months this mode of treatment was persevered in, (from the middle of August to the middle of October,) and when we saw the man about to leave the hospital in the first week of November, there was a shortening of the limb scarcely appreciable, the foot was nearly straight, and the patient felt in every way improved.Lancet.

Gastrotomy successfully performed for Internal Strangulation. The following interesting case is from the Dublin Hospital Gazette: -A man, 40 years of age, had had from infancy a reducible inguinal hernia in the left side. On the 7th of September, symptoms of strangulation appeared, but without the local signs of strangulated hernia.

12th September (seventh day), the patient was unrelieved; vomiting with constipation continued; the pulse was weak, and the patient greatly sunk; the abdomen was tense and tympanitic; the distended intestines formed prominent swellings. No trace of hernia existed in the inguinal region; the finger could be easily passed into the outer ring. After having been bled, the patient said the old hernial tumor had disappeared; internal strangulation was suspected, and gastrotomy was decided on.

The patient having been put under the influence of chloroform, M. Borelli cut transversely into the left iliac fossa, through the skin first, then through the muscles and peritoneum. A mass of large intestine protruded; no trace of strangulation existed, nor was any hernial sac to be found. The hand was introduced into the cavity of the abdomen, and at last a tight, hard ring was discerned, by which an intestine was strangulated. This was divided with a bistoury, (bistouri de Pott) the intestines replaced, and the wound closed by sutures, etc.

The operation lasted twenty minutes. Relief from vomiting was immediately obtained, but meteorismus and pain continued for two days without any alvine discharges. At last the bowels were freed. On the fourth day after the operation, the patient was twice blooded; on the fifth day, the bowels having been well freed, the patient was much better; his recovery was retarded by an attack of intermittent fever which yielded to quinine, and in the beginning of October he was quite well. - Gazette Medica Italiana.

MIDWIFERY.

Functional Derangement of the Liver, as a Cause of Uterine Disease. The following is an abstract from (Lancet) Dr. Mackenzie's paper on this subject. He believes that Hepatic Disease may cause Uterine Disease in three ways:

First, through the medium of the direct sympathy subsisting between the uterus and the liver; secondly, through the derangement of the assimilative processes, which invariably results from chronic hepatic disturbance: and, thirdly, through the debility of the nervous system, which sooner or latter inevitably follows upon long-continued derangement of any important organ of the body. From the first of this series of causes could be deduced many uterine affections of a variable and casual character, such as hysteralgia, leucorrhea, and menstrual irregularity; from the second, many functional and structural lesions of the uterus, of a more fixed and persistent character, such as congestion and inflammatory conditions, indurations, hypertrophies, fibrous growths, certain forms of leucorrhea, and rheumatic hysteralgia; from the third, a predisposition to uterine disease generally, the precise character and nature of which would vary with the nature of the exciting and other occasional causes. In connection with this part of the subject, attention was directed to the generally depressed state of the nervous system which accompanies the majority of uterine affections, and this, from various facts referred to by the author, was regarded by him as being rather due to the coincident hepatic than uterine complaint. The latter had, however, received greater attention, because, whilst the liver was an organ of dull sensibility, the uterus, on the other hand, had extensive sympathies with the sensorial parts of the nervous system, and its functional and structural conditions admitted of the closest scrutiny. The treatment of these cases should, in his opinion, be conducted with reference to three principal indications-first, to restore the tone and functional activity of the liver by the persevering employment of small, undebilitating doses of mercury, keeping strictly within the tonic and stimulating range of the remedy; secondly, to improve the assimilative functions generally, by careful attention to dietetic and hygienic measures, together with various therapeutical means, which were cursorily alluded to; thirdly, to restore the tone and vigor of the nervous system, which had been impaired by the long continuance of hepatic derangement. The general means adapted to this purpose were treated of, and the author took occasion to lay before the society some observations upon the remedial powers of amorphous phosphorus in certain affections of the uterine organs, attended with weakness and irritability of the nervous system. He had given it a large and extensive trial in these cases, and in some had found it remarkably beneficial. It could be given in doses averaging from ten to thirty grains, and, although insoluble, it readily diffused itself in water or any aqueous vehicle, and could be conveniently given in that way. It appeared to act as a direct tonic or stimulant upon the uterine system, and when properly prepared could be given without any risk or danger. He had given it with much success in certain cases of amenorrhea, hysteria, and passive menorrhagia. He had known pregnancy to supervene upon its employment after a lengthened period of sterility subsequently to marriage, and had found it useful in correcting the tendency to miscarriage when dependent upon morbid weakness or irritability of the uterine organs.

Premature Labor Induced by Means of the Douche. -By G. JONES, Esq. The first case was a female in her fortieth year, and in her ninth pregnancy. She had been attended in two previous labors by him, and the last was terminated by the use of the forceps; the previous pregnancies had either resulted in abortion, miscarriage, or, in one instance in which she proceeded to the full period of gestation, in being a twin case; the children in all were born with compressed and elongated heads, and generally died soon after birth. There was no deformity of the pelvis, properly so termed, it being of that kind known by obstetricians as the "pelvis æqualiter justo minor." At the expiration of the thirty-second week, July 3rd, 1854, he commencod applying the douche, using first hot and then cold water, by the aid of Higginson's India rubber enema apparatus, to which a small pipe of gutta percha had been attached, so as to be enabled to reach nearer the os uteri; the douches were repeated at intervals of twelve hours, and after the fourth douche pains came on and continued all night, but they subsided in the morning; these did not again occur until after the twelfth douche, and it required a thirteenth douche before they became effectual, and she was safely delivered, at 6 P.M., of a living female child.

He considered, on reflecting on this case, that if the douches had been followed up more quickly after the fourth, when the pains first came on, a more satisfactory result would have followed, and that no advantage had been obtained by alternating the temperature of the water used; consequently, in the next case, he determined to act on these convictions, and, as would be seen, with benefit.

The second case was that of a very short female, aged 28, with a curvature of the spine, and deformed pelvis, in her third pregnancy; she had been delivered in her two previous labors by craniotomy. Her menses ceased January 10th, 1854. August 3rd being the expiration of the thirtieth week, he commenced applying the douche, using, as in the previous case, the flexible caoutchouc apparatus, but only warm water; the injections in this case were applied for the space of a quarter of an hour, and repeated at regular intervals of four hours. Two hours after the fourth and last douche was given, he was sent for, and found the os uteri well dilated, and the membranes protruding to the os externum, and the pains following every five minutes. Labor was completed in another hour, being nineteen hours and a half from the administration of the first douche; the child was a living male.

On the Action of Digitalis upon the Uterus. By W. H. DICKERSON.-The writer commenced his paper by stating that during the month of October, 1854, a patient in St. George's Hospital, laboring under most severe menorrhagia, was cured by the infusion of digitalis, exhibited for the relief of cardiac affection, from which she also suf