to it that we do not allow ourselves to be diverted from the real objects of our pursuit to waste our time and energies in combatting senseless theories, which, left alone, will soonest reach the oblivion to which they are inevitably destined. Let us remember that the aim of the true physician is not the accumulation of wealth, or personal fame or aggrandizement, but the advancement of his science, the perfection of his art, and the emancipation of mankind from the bondage of disease; that he alone is the sole conservator of the public health, and that he alone is charged with the responsible and elevating duty of rescuing his race from the disease and death incurred by their own ignorance and recklessness. This duty and this responsibility is ours. We cannot go forth into life without taking upon ourselves all of life's duties and responsibilities. We may ignore or disregard them, but they rest upon us nevertheless, and we shall justly be called to render account for the manner in which we have improved the talents and opportunities which have been intrusted to us. No man can safely allow himself in any pursuit to be governed by self-interest alone. If we would not dwarf and cripple the highest and noblest elements of our being, we must seek to be governed by higher and nobler incentives. And what higher incentive to action than the consciousness that its object and its tendency are to prolong human life and rescue it from the thraldom of disease and suffering; to increase its pleasures and diminish its pains; to stay in its course the death scattering pestilence, and to cause that health and joyousness and thanksgiving shall prevail where otherwise would be death, disease and misery. Can we ask or seek a higher field or nobler work than this? Let us study to obtain higher and clearer views of the noble aims of our profession, that we may thereby be led to a more perfect consecration of all our energies to the great and ennobling work in which we are engaged.

The Retrospect.

SURGERY.

COMPOUND FRACTURE OF THE SKULL, WITH DEPRESSION-No SYMPTOMS.-We extract the following interesting case from the Boston City Hospital Reports, as published in the Boston Medical and Surgical Journal:

March 18th, 1868. H. S., aged forty-one, boiler-maker. While at work inside a boiler, a "drift-pin" was driven into his brain just above, and to the inside of, the right frontal eminence, close to the hair. A "drift-pin" is a piece of steel six inches long, one inch in diameter at one end and tapering to a point, and used in rimming out rivet-holes in a boiler. Patient's head was close up to the hole, and the workman who was at the wrong end of the boiler at work, struck the pin a sharp blow, and it glanced from the edge of the boiler and went through into the patient's skull.

He walked one-fourth of a mile to the hospital, and in a perfectly rational and natural manner related the preceding history; thought he was not much hurt, and insisted on going home, but of course was detained. Put to bed; cold applications to head. Light diet; face, eyes and tongue perfectly natural. No deafer than all are who work at boiler-making.

March 20th.-Pulse eighty, regular and strong; appetite good, and, with the exception of a slight drowsiness, feels as well as ever he did. Etherized and external wound enlarged. A ragged, irregular wound, three-fourths of an inch by one-half inch, found in the skull. Dura mater and brain lacerated, and small masses of the latter came out with the fragments of the skull. About a dozen pieces of bone were removed, varying in size from a grain of flaxseed to a finger nail; most of them were separated from the skull, and some of them were imbedded in the brain itself. Edges of wound in skull were so smooth that it was not thought best to meddle with them further.

Two hours after the operation, pulse seventy, regular and fair strength; no pain and has no opiate. No hæmmorrhage. Eyes, tongue and face normal. Cold water dressing.

Six hours after operation, pulse sixty, regular, good strength; feels a little confused in his head, but talks rationally. Takes iced milk with a relish.

March 21st.--Pulse seventy; slept well; bowels moved naturally. No cerebral symptoms.

March 31st.-Patient has not had a single unfavorable symptom since last report. Pulse has varied from sixty-four to seventysix, and has always been regular and of fair strength. Appetite good; has been out of bed several times, contrary to orders to be sure, yet there has been no mental derangement. Has been no hernia cerebri, on the contrary, the wound is gradually closing.

Suppuration healthy and moderate. Has not taken an opiate since he came to hospital. Had light diet for a few days, and since has had eggs, chicken, ale, &c. He feels as well and natural in every way to-day as he did before the accident.

A CASE OF STRANGULATED HERNIA IN WHICH THE SYMPTOMS CONTINUED AFTER THE REDUCTION OF THE TUMOR.-On the 5th day of March, 1867, I received a line from Dr. Haze, of Pickney, requesting me to meet him at the house of a patient of his about twelve miles distant, for the purpose of performing an operation in a case of Strangulated Hernia. I found the patient upon my arrival suffering from hiccup and vomiting, notwithstanding the tumor had been reduced nearly if not quite twentyfour hours. The case to us was a novel one. Neither Dr. Haze, Dr. Hassard, my assistant, nor myself had ever seen a similar We came to the conclusion that the sac had been returned with its contents, and that if he could bring it down again, the sac might be retained and the intestine returned. The patient was requested to make the effort to bring the tumor back, which was attended with success in less time, than we had anticipated. With my left hand I grasped the lower portion of the tumor, and by careful management succeeded in getting hold of a part of the sac containing a small quantity of fluid, enough to enable me to retain it, and with my right hand I reduced the intestine, upon which the patient exclaimed that he was better, and from that time none of the characteristic symptoms returned.

one.

The above case I deem worthy of reporting from its singularity, and the means adopted for its reduction.-[W. L. Wells, M. D., in the New York Medical Journal.

VERTICAL DISLOCATION OF PATELLA.-On the 12th of February last I was called to see R- H-, aged thirty-eight years, a rather tall and slender colored man, and found him suffering intensely from a vertical dislocation of the patella. Two days previous to the time I called, he was attacked with cramp of the muscles of the right foot and leg, and which resulted in a short time in the dislocation above alluded to. Dr. Davis was called in at the time of the attack and relieved the violent muscular contraction, but failed to replace the patella. Two days after the receipt of the dislocation, I was called, and found the patella firmly locked and embedded, with the internal margin resting in the condyloid cavity of the femur, and the external margin pressing tightly against the integument. There was so much tenderness of the parts at this juncture, that any attempt at reduction was rendered impracticable.

After reducing the swelling and tenderness of the parts, and relaxing to some extent the tendon of the quadriceps, which had up to this time continued in a state of rigid contraction, I made frequent attempts to replace the patella, but failed.

The limb had now been fixed and extended, and the patella immovably locked in its new position for more than two weeks, when I was again called in haste to see my patient, by his little boy, who said "Something was pulling Pap's knee again." When I arrived, I found that he had suffered another violent muscular contraction, but which had resulted this time in drawing the patella into its natural situation, and his suffering was ended.

Now, Mr. Editor, will you explain what freak got into the quadriceps, that it should, without any provocation, ruthlessly seize that great sesamoid and set it up on edge, and hold it there for a period of two weeks in spite of all entreaties to let go, and then of its own free will and accord dash it down in a fit of anger, and seem to mock at all attempts to coerce it. How do you explain such a result on the principle of muscular contraction?

This is an incident of very rare occurrence, and there is no case recorded, so far as I have seen, where reduction was effected by the counter action of the same cause that produced it.—[J. M. Boyd, M. D., in the Western Journal of Medicine.

PRACTICAL MEDICINE.

TREATMENT OF THE HABITS OF OPIUM-EATING.-We make the following extract from a very excellent lecture in the British Medical Journal:

In detailing to you the plan of treatment which I have found successful in cases of opium-eating, the first point to which I would direct your attention as being of the greatest importance is, that the sudden suspension of the habit is infinitely more efficient and easier to the patient than the gradual diminution of the dose; secondly, that the administration of large doses of phosphoric acid and lupulin materially helps the system in overcoming the immediate effects of the suspension of the drug and in checking the craving for a further supply; and thirdly, that the use of zinc, iron and quinine, in large doses, assists powerfully at a later period to restore the impaired health and strength of the patient.

Before, however, commenceing treatment, I find it well to speak frankly to the patient to warn him earnestly of his danger, and kindly to encourage him to a great effort and the endurance of considerable suffering with a view to an ultimate cure, which, without such effort on his part, is hopeless; in fact, to call forth, as far as is possible, an excercise of moral courage, which is of the last importance in this disease. When the character is thoroughly weak and self-indulgent, a permanent cure scarcely be expected.

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I feel certain that the sudden and complete suspension of the drug is less trying both to the physical and moral powers, than a gradual diminuation of the quantity; because, after every dose (however small) the same reaction takes place, the physical and mental craving remains the same, the temptations to an occasional increase are so many, and the trail is so protracted and exhausting, that very few have the courage to perserve.

OBSTETRICS.

CASE OF A MONSTER. "I was called on the 28th day of November, at four o'clock in the morning, to visit a woman, aged twenty-three years. On my arrival, which was soon after four o'clock in the morning, I found this woman in labor with her third child, and her pains short and frequent, which continued to be the case until eleven o'clock the same night, when she was delivered of a still-born female child, which had the appearance of coming at full time, and weighed eight and a half pounds.

"From all the evidences before me, I was led to the conclusion, that this child perished previous to the commencement of he labor; no motion of the child was felt during the labor; the uticle was detached in several places, and was very easily emoved with the finger.