he immediately completed his report, and handed it to the Secretary. It will also be remembered, by those present, that the honored and efficient Secretary, himself, presented, at the meeting, a highly important and valuable report. Unfortunately, however, this report then existed, in great part at least, only in the capacious brain of its author; and there, if anywhere, it still continued to exist, when last heard from. For three months and more past, this report, and this only, has been lacking, to complete the volume of the transactions. The facts speak for themselves; comment is unnecessary. What explanation the Publication Committee will have to offer to the next meeting of the Society, for this neglect of the duty and trust committed to them, remains to be the East to Denver, he has entered upon a thorough study of the climates of the various parts of the United States, especially in their relation to phthisis-causative, curative, or palliative. In the carrying out of this work, he is endeavoring to place himself in communication with leading physicians in all parts of the country, by means of a circular-letter, containing a series of carefully-arranged questions. It is to be hoped that physicians generally will respond promptly and fully to the inquiries, as the replies, when gathered together, will undoubtedly bring forward facts of the greatest value and importance relative to the effects of climate on disease. The Doctor we know to be well fitted for the task he has undertaken, both by natural ability and education. Unbiased and free from prejudice, he is not working to bring into prominence, or to present the claims, of some particular locality as a health resort, but is honestly endeavoring to carry out the work thoroughly and systematically. Dr. Denison is especially desirous of corresponding with such physicians. as are more particularly interested in the subject of climatic influences, in order to avail himself of their advice and assistance. F. H. D. MEANS FOR THE REMOVAL OF SYPHILITIC PIGMENT STAINS.-M. Langlebert suggests (Lyon Medical, from Gazette des Hopitaux) the application of blisters to old stains of syphilitic origin, and the continuance of the supburation, by the subsequent use of stimulating dressings, for a week. week. In this way he has caused brown stains, of several years' duration, to disappear.-Boston Med, and Surg. Jour. Gleanings from Our Exchanges. CASES ILLUSTRATING THE USE OF THE PNEUMATIC ASPIRATOR IN SURGERY. BY CHARLES D. HOMANS, M.D., BOSTON, MASS. From the Boston Medical and Surgical Journal. HE advantage of the use of the Taspirator, in enabling surgeons to make a diagnosis in cases where the existence of fluid is doubtful, seems to be pretty generally recognized; but practitioners do not appear to realize that this instrument is of great value in surgery, in the treatment of many other affections. It has been used for the removal of pus and synovia from joints, for the emptying of chronic abscesses, in cases of chronic hydrocephalus, of retention of urine, of strangulated hernia, and to relieve the pain of distention in cases of great flatulence. In all these cases-some, of necessity, mortalthe relief to pain is very great, while, as a rule, the punctures made by the aspirator needles have been followed by no serious consequences; in fact, in most cases, at post-mortem examinations, but little, if any, trace of their passage could be found. This instrument was used many times, during the past season, in my service at the City Hospital, and the following are some of the most striking of the cases: I. Strangulated Hernia. April 20th. P. B., laborer, aged 54 years, has had oblique inguinal hernia on the right side for the past ten years; he has always worn a truss, till within a week before entrance; three days ago, after exertion, the, hernia came down, and has remained down since, notwithstanding efforts at reduction were made by himself and two physicians. Constitutional disturbance not great. The hernial mass was about the size of a hen's egg, and very tender. The patient was etherized, and taxis tried for half an hour, without success. A fine aspirator needle was then thrust into the tumor, and from three to four drachms of fluid, containing bubbles ef air, drawn out. Taxis was then again resorted to, and the hernia immediately returned. No unfavorable symptoms supervened, and the patient was discharged, well, the eighth day after the operation. CASE II. Strangulated Hernia. May 26th. B. R., seaman, aged 27 years, entered the hospital with a large inguinal hernia on the right side, which had been down for several hours, and which he had vainly tried to reduce himself. He had been ruptured more than seven years, and had usually worn a truss of his own manufacture. Four years ago, he was operated on by a distinguished surgeon of London, by Wood's method, for the radical cure of the hernia; but the operation, at first apparently successful, was followed by a recurrence of the rupture, after seven or eight months. Since then, it has frequently come down, but he has always been able to return it without the aid of a physician. Now, there is a large hernial tumor in the right groin, very painful and tender. It is quite firm to the touch, and the skin over it shows the scars of the operation in London. There was some acceleration of the pulse, and the countenance was anxious. The patient was etherized, and attempts were made to reduce the hernia by | the taxis, by position, and in every way that could be suggested, but without success. The tumor was punctured with the fine needle of the aspirator, three successive times, but no fluid or gas passed out. The ordinary operation for strangulated hernia was then resorted to, and the tumor found to consist wholly of intestine, very tightly compressed, which may, perhaps, explain why no fluid or air came after the punctures. The patient did perfectly well, and was discharged three weeks after the operation. CASE III. Retention of Urine from Stricture. A man, aged 37 years, entered the hospital with his bladder distended with urine, none having been passed for thirty hours. Many attempts had been made to pass an instrument through the urethra, but without success. There was a stricture four inches from the meatus, and blood followed the attempt to pass the catheter. The fine needle of the pneumatic aspirator was passed into the bladder, behind the pubes, and three pints of urine were drawn off. The bladder was punctured again the next day, after which the urine came naturally. CASE IV-A man, aged 28 years, was brought to the hospital, having fallen astride a plank ten hours before, and having been unable to empty his bladder since. He was suffering greatly from distention, and the aspirator was immediately used, as in Case III., forty ounces of urine, slightly tinged with blood, being drawn off. It was afterwards necessary to perform perineal section; and the man eventually recovered. Dr. Wm. Ingalls also used the aspirator in a case of retention of urine from stricture, with similar good results; and it was used many times for emptying abscesses, exploring tumors, etc. Its use in one of the cases of strangulated hernia was, apparently, of the greatest service, while, in the other case, no harm was done, though three punctures were made. In the cases of retention of urine, the advantage of this manner of relieving suffering is certainly very striking, over the old way of tapping through the rectum. The needle is more easily introduced, if a very slight puncture is first made through the skin. RHEUMATOID ARTHRITIS. CASES FROM CLINIC OF PROFESSOR DA COSTA, IN PENNSYLVANIA HOSPITAL. T From Philadelphia Medical Times. HE affection which we are about to consider has been known by various names, such as rheumatic gout, rheumatoid arthritis, etc., which latter has been generally adopted as a sort of compromise between the two prevailing and contending theories as to its nature rheumatic or gouty. It affects persons of an anæmic or scrofulous constitution, and is usually traceable to exposure to cold or damp. It begins with slight swelling of the smaller joints, as a rule, with tenderness, but no discoloration. The swelling is due to an inflammation, with effusion of water or pus, which finally subsides, and the swelling disappears. This is now followed by a thickening of the synovial membranes, and the formation of " vegetations," which gradually harden, and stiffness of the joint supervenes. Second attacks are apt to follow upon partial convalescence, leading to complete disorganization of the joints affected; finally, we find loss of articular cartilage, the bones, becoming eburnated, produce the peculiar grating sound noticed when the joints are moved. Dislocation is a frequent sequence. The constitutional involvement is peculiar, and, as we become more familiar with the disease, affords a valuable aid in its diagnosis. It is usually subacute, and presents no feverphenomena, no uric acid or increase of fibrin in the blood, and no acid perspiration; neither are there deposits in the finger-joints and ears, as in gout. There is no history of hereditary rheumatism or gout. The absence of cardiac symptoms is pecu These lesions are so intimately associated with rheumatism as to warrant the assertion that four-fifths of the cardiac diseases are attributable to rheumatism. These points in the diagnosis and clinical history are B.-Potass. iodid., 3 ij. Lin. sapon. camph., f 3 vj. To be applied morning and evening. proofs of its being a distinct disease maniacal and mercurial plaster good purpose. now used the hospital is: remedies par excellence. gr. iij. to v. A formula Arsenic is valuable; in fact, no case should be pronounced incurable until it has been tried. If the nutrition fails, the system may be supported with stimulants, as there is no contra-indication, as in gout or rheumatism. They are not to be used in the acute form of the disease, how Appended is the clinical history ofinternally od liver oil, potass. two cases in point: CASE I.-A man, aged thirty years 9 citrate of lithia, are the iodid., liq. potass. arsenit., iodide of a shoemaker by trade, first became affected, two years since, with so ing, pain, and stiffness in the greaARY, Afervescing citrate of lythia, toe' of the left foot, which have en tended to all of the larger joints. He gave, upon admission, a history of previous good health; never had fever during the progress of his disease; never had syphilis; and there is no family history of gout or rheumatism. It came on gradually. His urine is normal, bowels regular, and he has a good appetite. He has lost flesh, but is now gaining again. The hands present the peculiar distorted appearance of the disease, and there is "grating" upon motion; the large joints are alike affected, being rigid and painful upon motion. Auscultation reveals, at the base of the heart, a soft, systolic murmur, which is not constant; there is no hypertrophy. He has been taken citrate of lythia and cod liver oil; this, conjoined with baths and regulated diet, has produced favorable results. CASE II-A French sailor, who has been in the house five days, states that he has been affected two months, giving no acute history; there is some stiffness of the smaller joints; entire absence of heart-lesions; no fever, tongue somewhat coated; pulse and temperature normal. This patient might take, with advantage, lithia, cod-liver oil, or ar ever. Baths should be insisted upon; for this purpose, tepid water and carbonate of soda may be employed; or Turkish baths may be used. Finally, a change of climate may be of service. MENSTRUATION AND OVULATION. -The entirely separate character of these two physiological processes is argued by Dr. H. Beigel, in the Weiner Medicinische Wochenschrift. Further, conception is independent of menstruation. Young women conceive before they menstruate; in cases of double ovariotomy, women menstruate when they cannot conceive. Menstruation he defines as "a periodically recurrent sexual impulse," the exact signification of which expression is obscure to us.-Philadelphia Medical Reporter. A CASE OF POISONING BY FIVE GRAINS OF STRYCHNINE TREATED BY CHLOROFORM INHALATIONS. RECOVERY. As the following case may be of some interest, I will submit it to the profession : Mr. B., shop-keeper, a middle-aged man of temperate habits, while suffering from depression of spirits, obtained, on September 1st, ten grains of strychnine, representing his intentions were to poison a dog. He secured a room at a hotel, took a dose of laudanum as a preparatory step, and went to bed, intending to swallow the drug as soon as the effects of the opiate were apparent. It appears he fell asleep, and did not awake till half-past four in the morning, when he took half of the quantity previously mentioned. Some time after, he was seized with convulsions. The occupants of the adjoining rooms, awakened and alarmed by his screams, at length came to his relief. I was called, and saw him at 6 A.M. I found him lying in bed; legs and arms extended, his hands firmly clenching the sides of the mattress; intellect clear. He confessed he had taken strychnine. The clothing, by his request, had all been removed, as the slightest touch produced a spasm. I administered twenty grains of sulphate of zinc as soon as it could be obtained. This he swallowed with great difficulty, the contact of the solution with his mouth producing trismus and constriction of the throat. The paroxysms came on every three or four minutes. He was conscious of their approach, and entreated us to hold him, to raise him up, or lift him out of bed, till his body became fixed, his head drawn back, and articulation impossible. In this condition of complete opisthotonos, he remained for about a minute, his face livid, and death apparently inevitable. I now resorted to chloroform inhalations, with the happy result of preventing each paroxysm from lasting over a few seconds, or subduing it before the muscles of the back became rigid. So soon as he felt one coming on, I applied the vapor to his mouth; when 1 the muscles were completely relaxed and the breathing natural, I removed it. The convulsions returned regularly till 2 P.M.; the intervals then grew longer until 5, when the paroxysms entirely subsided. For some time after he regained the use of his hands and arms, the legs could not be touched without producing a shock, as if the poles of a battery had been applied. In the eleven hours, he had used over a pound of chloroform. During the night and next day, I found it necessary to relieve the bladder with the catheter. The following evening - thirty-six hours after I first saw him- he was taken home in his carriage, and a week subsequently he walked to my office, although still suffering from soreness and stiffness of the muscles. If we do In this case, the sulphate of zinc did not produce emesis, nor did I repeat the dose, feeling confident the drug must already have been absorbed. And here I would state that the treatment given in all the books, viz., "give emetics, and persist in their use until free emesis is produced," should at least be modified. not see the patient till a quarter of an hour after the poison is taken, or if convulsions have set in, emesis will surely do much harm. In a case I saw in Philadelphia, in 1868, the patient was nauseated with doses of sulphate of zinc and ipecac. Each attempt at emesis produced the most alarming convulsions. With chloroform to ward off the convulsions till the poison is eliminated from the system, deaths from strychnine will be very rare.-G. W. COPELAND, M.D., in Boston Medical and Surgical Jour. ABORTIVE TREATMENT OF FURUNCULI.-According to several observers, as recorded in the French journals, the following method never fails "to take effect:" As soon as there is perceived that characteristic redness, round in form and variable in size, with a culminating point in the center, which, red at first, soon turns to a grayish-white, dip the finger into a little camphorated alcohol, |