accident. First, the patient was a multipara, with a very relaxed and dilatable cervix uteri, and perhaps there was a want of tenacity in this part of the organ, associated in her with the absence of sensation during uterine action. Secondly, the placenta was placed very low down on the uterine wall, for the opening in the membranes was bounded in part by the placental margin; while, thirdly, the umbilical cord was inserted into the placenta within an inch of that part of its border;-two conditions the importance of which have come to be abundantly acknowledged since the younger Naegele specially called attention to them, in an essay on the subject. I might add, that the cord was of more than average length, and measured 21 inches, for this, too, has been noted in connection with prolapsus of the cord; but what exact share is to be attributed to each of these elements in the production of the complication, it would be difficult to decide, for it is a kind of case in which the mind of the accoucheur is for the time less taken up with the cause than with the cure; he is more anxious to avert the consequences of the accident, than to determine how it was produced.

"And here let me observe, that the great variety of expedients that have been adopted for the remedy of this complication, and the vast variety of instruments that have been contrived for the reposition of the descended cord, are a sufficient indication of the imperfection and unsatisfactoriness of each and all of them. And when we look to the recorded results of these various forms of treatment, and find that, even in the best hands, little more than two thirds of the children are saved, while the average mortality in the general mass involves more than half, we are prepared to welcome a suggestion so simple and safe, and to adopt a measure so satisfactory as that described in 1858, by Dr. T. G.Thomas, of New York, under the designation of The Postural Treatment.' Although six years have already elapsed since Dr. Thomas read his essay before the Academy of Medicine, the proposal is not widely enough known, or, at least, the results of the practice have not been recorded in sufficient abundance to allow us to make a statistical comparison of it with the multiform methods of treatment which it promises to replace. But I am well assured that when it shall come to be adopted as the common method of treating cases of prolapse of the cord, when interference is required, the high mortality of this complication will be found to be very materially diminished.

"In the special case before us, the result was in every respect most grati fying. Having placed the patient on her elbows and knees, I passed the fingers of the right hand into the vagina, and carrying down the displaced loop of cord into the os uteri, I could feel it slip away past the presenting head into the dependent uterine cavity. Friction was then applied to the uterus increase the contractions; and these having been still further stimulated by the administration of a fuil dose of ergot, and the head having fairly entered into the pelvic brim, the patient was made to resume the ordinary obstetric position in about a quarter of an hour from the commencement of the opera

tion.

5th. Application of the Forceps.-The uterus continued to contract regularly and steadily, though painlessly, but the advance of the head was so very slow, in consequence of its large size and extreme ossification, that after the lapse of an hour and a half or two hours, I deemed it right to act on the principle, which has ever received the hearty sanction and support of this society, that we ought to interfere to avert the evils of delay, rather than to wait till nature has done her utmost, and left the patient prostrate, and perhaps after all undelivered. The woman was accordingly brought under the influence of chloroform, when Dr. Watson applied the forceps and speedily effected her delivery. With the birth of the child in this manner, all peculiarity in the

* H. Fr. Naegele, Commentatio de causa quadam prolapsus funiculi umbilicalis in partu, non rara illa quidem, sed minus nota. Heidelb. 1839.

history of the case terminates. But I may still be permitted to add a few sentences as to the way in which we conducted.

"6th. The Management of the Third Stage of Labor.-With the left hand over the abdomen, I followed down the contracting uterus as the body of the child was being expelled from its cavity; and then grasping the uterus at first gently, and then with more force, I compressed it until, within five or six minutes, the placenta, with the membranes was driven into the vaginal orifice, and removed. At first sight it will be averred that there was nothing new in this kind of procedure; and it is not as a novelty in practice that I mention it now. Yet I apprehend that though a few practitioners in the midst of us are in the habit of following out this plan in most of their cases, the ordinary practice of the profession in Britain materially differs from it, and consists, as we find laid down in all our text-books, of waiting ten or fifteen minutes till the return of uterine contractions may have detached and expelled the placenta, then examining to discover the position of the afterbirth, and removing it; and when it does not come away at once, making gentle traction on the cord; while the uterus is stimulated to more energetic action by occasional friction, but not with such a forcible degree of compression as would suffice to separate and squeeze out the contents. Or if, in the practice of some obstetricians, the external manipulation of the uterus is insisted on as the chief element for successful completion of the third stage, yet even with them the internal interference with the cord and placenta is not entirely laid aside."-Edinburgh Med. Journ., April 1864.

CITRATE OF MAGNESIA.-The following mixture for the extemporaneous preparation of the solution of citrate of magnesia is recommended by M. Parisel. The gramme, it will be remembered, is equivalent to 15.4 grains.

Take of powdered and well dried citric acid, 200 grammes; carbonate of magnesia, 120 grammes; mix accurately, and inclose the powder in a slightly warmed and well-dried bottle, which must be well stopped. The mixture thus made is rapidly dissolved in three times its weight in water, at the ordinary temperature; and, if the water be pure, the solution in a few minutes becomes perfectly transparent, without any precipitate. The salt preserves its solubility a long time.-Bull. Gen. de Therap.

POWDERED ALUM IN CHRONIC CATARRH OF THE AUDITORY MEATUS AND TYMPANUM.-According to the statement of M. HIMLIN in the Medical Times and Gazette, the application of powdered alum by insufflation will be found very effective in certain forms of chronic catarrhal inflammation of the meatus and tympanum which are otherwise often tedious in yielding to treatment. When there exists a red and granular condition of the membrana tmpani, with or without the minute polypi, such as often last from childhood to an advanced period of life, the use of the remedy will be especially suitable after all the more acute symptoms having subsided. The alum is readily introduced by a moistened camel's hair brush, or it may be blown into the meatus through a piece of india rubber tubing. The ear should always be gently syringed out with tepid water before using the powder. A few efficient applications will usually remove the unhealthy condition of the membrana, after which the discharge dependent upon it will subside. Unless other lesions are present the hearing will still gradually improve.

DIETETICAL PROPERTIES OF PHOSPHORUS.—At a late meeting of the American Medical Association a voluntary communication on the Physiological and Dietetical Properties of Phosphorus was read by Dr. John H. Griscom, of New York.

After a detailed exposition of the extent and amount in which this substance is found in the various tissues, fluids, secretions, and excretions of the body; there being scarcely one in which it is not a constituent, whereby its importance is properly inferred-the practical application was made of the influence of a deficiency of phosphorus in a variety of diseases of the osseous, nervous, muscular, digestive and respiratory organs. Scurvy, resulting from too free use of salted food, was shown to be probably due to the loss of the phosphates, which LIEBIG has proved to be removed by the salt, and is found in the brine. Fresh meat, as well as fresh vegetables, proves to be an antiscorbutic, doubtless in both cases on account of the phosphoric acid. It was further shown that modern modes of preparing food of several kinds deprived it of this element to a large extent, to which many evil results are attributable. Especially is this the case with that "life preserver of the world " the wheat grain. By the bolting process, 14.00 per cent. of this element is lost. Several specimens of Farina Cocido, or roasted wheat, as extensively used in South America, were presented to the section and highly commen ded as substitutes for superfine flour, retaining as they do, all the phosphatic matter of the grain. The paper elicited many favorable remarks, and was unanimously recommended to the Association for publication in the Transactions.-Philadelphia Med. and Surg. Reporter.

SUBSTERNAL TENDERNESS A DIAGNOSTIC SIGN OF ACQUIRED SYPHILITIC TAINT.-The Edinburgh Medical Journal contains an abstract of a paper by Mr. BRODERICK of Madras, who says: "Substernal tenderness can only be detected by pressure over the bone and when searching for it formerly, I used to carefully knead the bone with the fore and middle fingers, from the manslim to the xyphoid cartilage. In a case of suspected constitutional syphilis, if the patient asked if he had pain in his breast bone, he will probably answer in the negative. The medical man should then knead the sternum carefully and gently along the whole of its course, and the tender spot will generally be found at the commencement of the lower third." With much practice and observation he frequently succeeds in touching the spot at once, much to the surprise of the patient who often is not previously aware of the existence of this tenderness." Dr. BRODERICK further states: "If the substernal tenderness be found, I believe we are quite safe in assuming that the subject of it labors under acquired venereal taint, which may have been masked by divers symptoms and be quite unsuspected both by patient and surgeon." In suspected cases look for them, for the tenderness which usually will be found at the commencement of the lower third occasionally in the upper third and very seldom in the intermediate space.

NEW ANESTHETICS.-The Intellectual Observer mentions that Dr. Genges has addressed a note to the French Academy detailing some very interesting experiments performed by him in this direction. He has ascertained that a purified kerosoline, obtained from commercial petroleum oil, when vaporized by means of heat, will be found a valuable anaesthetic. He especially recomiends, as safer than chloroform, bromhydric ether, which not only is less inflammable than ordinary ethers, but possesses an exquisite odor.

Treat such

ON CHRONIC ULCERS.-By Frederick C. Skey, Esq., F. R. S., &c.—The more chronic the ulcer, the larger its size, the more aged the subject, the more remarkable is the influence of opium in effecting its cure. a case of chronic ulcer of the largest size, having a pale, flat, bloodless base, high mound of lymph around it covered by unhealthy integument, the sore pouring out a large quantity of watery ichor, saturating the linen, stockings, and other appliances-I say, select such a case occurring in old age; give such a man ten or fifteen drops of tincture of opium night and morning, leave his bowels alone, and observe the base of the sore in five or six days; it will exhibit a number of minute red points, which, daily increasing in number, will rise up in the form and identity of healthy granulations, and cover the entire surface of the ulcer. Contemporaneously with the gradual elevation of the base of the ulcer is the descent of the surrounding eminence and the commencement of the process of cicatrization. If I desired to select an ulcer, on behalf of a student, with a view to illustrate the character of perfect granulations as they appear in a thoroughly healthy example, I would select an ulcer which had been treated by opium in preference to any other. If it be supposed by any man having a limited experience in the employment of opium that any evil to the constitution attaches to the use of that valuable agent, I can only reply that its salutary action on the ulcer is obtained solely through the healthy influence it exercises on the constitntion. Judiciously employed, no drug in our pharmacopoeia is more innocuous.—Lancet.

ON THE SUPPOSED IDENTITY OF BILIVERDIN CHLOROPHYLL, WITH Remarks ON THE CONSTITUTION OF CHLOROPHYLL. BY G. G. STOKES, M. A., SEC. R. S.-I have lately been enabled to examine a specimen, prepared by Professor Harley, of the green substance obtained from the bile, which has been named biliverdin, and which was supposed by Berzelius to be identical with chlorophyll. The latter substance yields with alcohol, ether, chloroform, &c. solutions which are characterized by a peculiar and highly distinctive system of bands of absorption, and by a strong fluoresence of a blood-red color. In solutions of biliverdin these characters are wholly wanting. There is, indeed, a vague minimum of transparency in the red; but it is totally unlike the intensely sharp absorption band of chlorophyll, nor are the other bands of chlorophyll seen in biliverdin. In fact, no one who is in the habit of using a prism could suppose for a moment that the two were identical; for an observation which can be made in a few seconds, which requires no apparatus beyond a small prism, to be used with the naked eye, and which as a matter of course would be made by any chemist working at the subject, had the use of the prism made its way into the chemical world, is sufficient to show that chlorophyll and biliverdin are quite distinct.

I may take this opportunity of mentioning that I have been for a good while engaged at intervals with an optico-chemical examination of chlorophyll.

I find the chlorophyll of land-plants to be a mixture of four substances, two green and two yellow, all possessing highly distinctive optical properties. The green substances yield solutions exhibiting a strong red fluorescence ; the yellow do not. The four substances are soluble in the same solvents; and three of them are extremely easily decomposed by acids or even acid salts, such as binoxalate of potash; but by proper treatment each may be obtained in a state of very approximate isolation, so far at least as colored substances are concerned. The phyllocyanine of Fremy is mainly the product of decomposition by acids of one of the green bodies, and is naturally a substance of a nearly neutral tint, showing, however, extremely sharp bands of absorption in its neutral solutions, but dissolves in certain acids and acid solutions with a green or blue color. Fremy's phylloxanthine differs according to the mode of preparation. When prepared by moving the green bodies by hydrate of alumina and a little water, it is mainly one of the yellow bodies; but when prepared by hydro-chloric acid and ether, it is mainly a mixture of the same yellow body (partly, it may be, decomposed) with the product of decomposition by acids of the second green body. As the mode of preparation of phylloxantheine is rather hinted at than described, I can only conjecture what the substance is; but I suppose it to be a mixture of the second yellow substance with the products of decomposition of the other three bodies. Green sea-weeds (Chlorospermeœ) agree with land-plants, except as to the relative proportion of the substances present; but in olive-colored sea-weeds (Melanespermen) the second green substance is replaced by a third green substance, and the first yellow substance by a third yellow substance, to the presence of which the dull color of those plants is due. The red coloring matter of the red sea-weeds (Rhodospermen), which the plants contain in a dition to chlorophyll, is altogether different in its nature from chlorophyll, as is already known, and would appear to be an albuminous substance.-St. Louis Med. and Surg. Journal.

SUDDEN DEATH IN CONTUSIONS AND FRACTURES FROM PULMONARY EMBOLI -The Med. Times and Gazette contains an abstract from a paper by M. AZAN, before the Academy of Medicine, wherein the following conclusions were reached: 1. Fractures and contusions may give rise to sudden death through pulmonary embolism. 2. The emboli originate in a thrombosis of the veins of the injured region, itself due to the absorption of effused blood. 3. These thromboses, or the phlebitis which precede them, are generally latent, and are of more common occurrence than would at first sight be supposed. 4. The explorations by means of the finger of the track of the veins can alone demonstrate their existence. 5. Sudden pulmonary accidents, as dyspnoea, hæmoptysis, precordial pain, syncope, etc., indications of the presence of an embolic coagulum of varying size, may direct the attention of the surgeon to the phlebitis. 6. In venous thrombosis the coagula are more or less adherent, and the plasticity of the blood is proportionate to the solidity of the adhesions. Fractures compelling repose are unfavorable to plasticity. 7. The various movements of the parts, and the application of apparatus, may favor the detachment of the coagula. 8. The surgeon should investigate whether, from the fifteenth day, in cases of fracture or contusion, latent phlebitis does not exist. 9. If this is discovered, rest, antiphlogistics, and an a kaline treatment are indicated.