A Case of Worms in the Urinary Bladder. Dr. Melvin Rhorer reports (Am. Practitioner, March, 1875), the following case which he was called to see in consultation: The patient, aged sixty-four years, was a farmer, who had for the past twelve months been affected with occasional interruptions to the flow of urine, which for the last three weeks had increased in severity, causing great pain in evacuating the bladder, and which now amounted to almost a total retention. His bladder was very much distended, he having passed no urine for forty-eight hours, except a constant dribbling of highly-colored urine, with an occasional drop or two of blood. Dr. R. easily introduced a catheter and evacuated the bladder, finding in the vessel forty or fifty small red worms about half an inch in length, and having a number of legs arranged in two distinct rows from one extremity to another, and their bodies being encircled with numberless small cartilaginous rings. It was with some difficuity that he pressed a lancet through the body. In about two hours the patient, at his suggestion, forced a passage from his bladder, amounting to several ounces of urine, with about half a dozen more worms. No attempt was made to sound for stone, the diagnosis being too clear as to the cause of the trouble. We ordered spirits of turpentine internally, and the catheter to be employed daily. For the following ten days he passed from four to six worms every action; since which time he has voided urine without the use of the instrument, and the discharge of worms had ceased. He has no pain on micturition, and is free from his late trouble, except a sense of soreness over the hypogastric region. [For references to similar cases the reader is referred to Gross On the Urinary Orguns, and Roberts On Urinary and Renal Diseases, 2d ed., Phila, 1872, p. 590].-Monthly Abstract Medical Sciences. :0: The Sense of Taste. The precise physiology of the sense of taste is a subject to which a good deal of attention has been devoted, but there still remains some obscure points to be solved in connection with it. It is well known that a great number of the sensations commonly included under the name of taste are in reality appreciated by the olfactory nerve. This is the case with nearly if not quite all of the aromatic and odorous flavors, as is clearly seen in cases of anosmia; whilst sour, salt, and astringent tastes are due to impressions on the nerves of common sensation, and are probably the results of chemical action. But the appreciation of "sweet" and "bitter" tastes is a special function, located in certain limited areas of the tongue, which are provided with special forms of papillæ, and to a small portion of the palate and fauces. Of these, the anterior portion of the tongue, close to the tip, and the posterior third of the dorsum are the most important, both possessing the power of discriminating sweet and bitter; but the anterior portion being apparantly more sensitive to sweet, the posterior to bitter tastes. The latter area is supplied by the glosso-pharyngeal nerve, which appears to act as the taste nerve; but with regard to the former, which is supplied by the lingual branch of the fifth, some doubt exists. Dr. A. Davidson, of Liverpool, has recently drawn attention to the subject in a paper, "On the Sense of Taste, and its Relation to Facial Paralysis and Anaesthesia," in which he discusses the various views which have been advanced, and relates three cases bearing upon the question. The results of clinical observation and of physiological experiment appear to show conclusively that the sense of taste in the anterior area is dependent upon the integrity of the chorda tympani, since injury to the fifth nerve, above the junction of the latter with it, although accompanied by complete anesthesia of the side of the face and tongue, does not necessarily affect the sense of taste; whilst on the other hand, when the chorda tympani is injured or cut, taste is lost without loss of sensation. According to some, who regard the chorda tympani as a purely motor nerve, this is due to the affection of the functions of the sub-maxillary gland, or to the loss of power of erection of the taste papillæ. Neither of these explanations, however, appear to be satisfactory, and the weight of evidence would seem to be in favor of the view that some of the fibres of the nerve are afferent. In one of Dr. Davidson's cases there was complete paralysis of the portio dura on the left side, of deep origin, accompanied by entire loss of taste in the corresponding half of the tongue in the anterior part. In another case there was right facial paralysis from disease of the internal ear, and loss of taste on the right side of the tongue. In the third case there was complete anesthesia of the parts supplied by the fifth nerve on the right side, probably resulting from a fracture of the skull; but although there was complete loss of sensation on that side of the tongue, the sense of taste was for some time unaffected. Its subsequent impairment is ascribed by Dr. Davidson to the changes in the mucous membrane of the tongue consequent upon impaired innervation. This case may serve to explain some anomalous cases in which injury to the fifth was associated with impairment of taste. Dr. Davidson believes that the taste nerves pass by the chorda tympani to the facial and thence probably by the nerve of Wrisberg to the brain.-Lancet.American Medical Weekly. Transfusion. Prof. Mosler, of Griefswald, has recently reported in the Berliner Klinische Wochenschrift (May 17) the details of a case in which a woman who had some hours lain pulseless and unconscious from intestinal hemorrhage due to typhoid fever was immediately and permanently revived by transfusion practiced into her radial artery. Defibrinated blood from a healthy man was used. This is said to be one out of four cases, and the second successful one, in which transfusion has been used in the hemorrhage for enteric fever. There is one point in the case to which we desire to call especial attention. Prof. Mosler performed the operation in the unusual way employed, avowedly to avoid the risk of distending and thereby paralyzing an excessively weak right ventricle. Several cases abroad have proved instantaneously fatal from cardiac paralysis, evidently simply the result of over-distention of a right heart already scarcely able to fulfil its duties. One of the most terrible dramatic scenes we ever saw owed its chief interest to the same misfortune. The patient, a little French boy, in a foreign clime, pale and waxy from advanced leucocythæmia, surrounded by doctors, sat up in bed with an expression of mortal terror as he watched the preparations for the operation; screaming when the trifling incision was made; outwardly calm, but panting, with nostrils distended, as the syringe was introduced into the canula. Suddenly, as the piston went up, a frightful deadly pallor, a look of mortal agony, a start and a cry, with upthrown arms, "Mon Dieu! je vais mourir!" a gasp, a shudder, a heavy fall back upon the pillows, and the life was ended. In this case, at the autopsy, the cardiac walls were found to be thin, and the muscles degenerated, whilst a large pericardial effusion added to the heart's embarrassment. As there was no reason for suspecting any entrance of air into the veins, the death was evidently wrought out in the manner described.-Philadelphia Medical Times, Editorial. :0: On Fibroids of the Uterus: Intra-uterine Myomata. M. Stoltz, writing in the Revue Medicale de 'l Est, February 1, 1875, says that pedicellated fibrous bodies, commonly known by the name of polypi, arise either from the cavity of the body or from the neck. The former are not properly pedicellated, but adhere to a more or less limited surface of the uterus; they are really sessile. They become pedicellated by the excessive uterine efforts at their expulsion. When in the vigina, they are not really pedicellated. Should the part to which they are attached offer considerable resistance, the capsule may become elongated into a veritable pedicle. As a rule, the fibrous body draws down with it the portion of the uterine wall to which it is attached, causing an inversion of the uterine parietes, allowing thereby the polypus to project into the vagina. This fact should never be absent from the mind of the operator, whether the polypus be still within the uterine cavity or protruded into the vagina, or replaced into the uterus, or drawn down by the manipulator into the vagina. The first object is to make out whether the tumour is pedicellated or sessile; if the latter, the extent of the base. Should it prove to have a wide base, he strongly recommends making a couple of incisions into the capsule with a pair of curved scissors; the tomour then peels out of its capsule as the rind does from off an orange. He has done this operation many times with success; as a rule, it is the most expeditious and least dangerous method of dealing with these growths; but he admits exceptions. The wire écraseur he objects to, on account of the danger of cutting the uterus, which has been the case more than once in the hands of the most skilled operators. Professor Braun-Fernwalt, for the same reason advises the tumour to be cut in halves, or a piece cut out of it with the galvanic wire cautery. Other authors strongly recommend that the patient should not be anaesthetized before tightening the wire of the écraseur, as, from the uterine tissue being a sensitive structure, her sensations will be a fair guide as to whether the uterus has been impinged upon or not.-Medical Abstract. ·:0: Editorial. The Medical Profession in California. The San Francisco News Letter, a weekly paper, began some months since to publish from week to week, a list of quacks, including with the most notorious charlatans a number of respectable practitioners. The Pacific Medical and Surgical Journal has until the present time seen fit to say nothing about the subject, preferring to let the matter alone and watch developments. The recent action of the London Lancet and the Boston Medical and Surgical Journal, in giving credence to these stories, has, however, called forth a reply from the Editors. They boldly assert, that the News Letter published the list and statements for purely black-mailing purposes, and state that several physicians, whose names were included in the list, had them removed by paying sums of money. We are sorry that a professional journal would extend this slander without inquiring into the facts more particularly, but we have no doubt that the Editors of the Lancet and Boston Medical Journal will both hasten to make ample apology, on being informed of the untruthfulness of the charges to which they have given publicity. The difficulty seems to have been increased by certain members of the medical profession, who, we are sorry to say, from selfish and malign motives, sought to aid the News Letter in slandering, and took the occasion to avenge themselves upon members of the profession who had incurred their enmity. It is a sad truth, that such men can be found in the ranks of what should be in every sense a learned and liberal profession, but if the San Francisco physicians can, by this trial, rid themselves of a few of them, they will be amply repaid for the slander which has been circulated against them. They have our sympathy and best wishes for a triumphant vindication of the right. CENTENNIAL NUMBER.-The Boston Medical and Surgical Journal for June 17th is a centennial number, and is devoted to historical matters of professional interests. The number is illustrated by a copper-plate portrait of Gen. Joseph Warren, M. D., and opens with a sonnet, by Dr. O. W. Holmes, which contains so many features of beauty that we produce it here: JOSEPH WARREN. Trained in the holy art whose lifted shield Following are papers upon the medical profession of Massachusetts at the time of the Revolution, by Dr. George B. Loring; on the Medical Department of the Continental Army, by Dr. J. M. Toner; a translation of a Hessian surgeon's notes of his American experiences; extracts from Gen. Warren's note-book; reminiscences of a Tory surgeon's part in the battle of Bunker Hill; and a letter from Charleston, S. C., on historical subjects. The number is a very interesting one, and especially is it so at this time, the centennial of the period it for the most part commemorates.- -CHANGE OF DRESS.-The Pacific Medical aud Surgical |