unavoidable, perfect recovery followed the prolonged application of the iodoform. Apart from its action as a resolvent, iodoform has the property of relieving pain: Dr. Moleschott hence recommends its use in painful attacks of gout and also in various forms of neuralgia. In a case of intercostal neuralgia, he gave it internally in the form of pills (three-fourths of a grain daily) as well as externally. In severe neuritis, he has used iodoformed. collodion successfully after other treatment had been tried in vain. Administered internally, it will probably be useful in the palpitations of nervous and hysterical patients, and will restore the regularity of the heart's impulse, Its offensive smell is obviated by mixture with tannin.-British Med. Journal, Sept. 28, 1878.

Nitrite of Amyl in Ague.-Dr. W. E. SAUNDERS, of Indore, calls attention (Indian Med. Gazette, No. 39.) to the value of nitrite of amyl in ague, and records a number of cases in which advantage has been derived from its use. The drug itself, he remarks, is inexpensive and goes a long way. He now uses nitrite of amyl mixed with an equal part of oil of coriander, to render it less volatile, and at the same time to cover its odour. He regards it as the most powerful diaphoretic he has seen, and he uses it in all cases of fever to produce diaphoresia. The following is one of his cases: Mr. C. came for treatment about 7 P. M. in the cold stage of ague. Two minims of nitrite of amyl were administered; sweating came on in seven minutes. He lay down for half an hour to get cool, and then walked home well. He next morning took a dose of quinine, and has had but one attack of fever without the cold stage since. Previous to this he had fever every day for one month, during which he took large doses of quinine. Dr. Saunders observes that he does not mean to say that quinine should not be used in these cases, for there is ample proof that it tends to check the return of the attacks, and removes to some extent the septic condition of the blood induced by the malarial poison, and this more especially if small doses of opium be combined with it. In no case did the amyl fail to remove the attack in about one

third the usual time, and in most cases the fever did not return. The method of administration he adopts is this: Four drops of the mixture, or two drops of amyl are poured on a small piece of lint, which is given into the hands of the patient, and he is told to inhale it freely. He soon becomes flushed, and both his pulse and respiration are much accelerated, and when he feels warm all over the inhalation is discontinued, as the symptoms continue to increase for some time afterwards. A profuse respiration now sets in, which rapidly ends the attack; in some cases, however, the cold stage merely passed of without any hot or sweating stage-Practitioner.

Harmlessness of Urea in the Blood,The London Medical Record mentions experiments by MM Feltz and Ritter, to show that pure urea never brought on convulsive symptoms. Urea injected into the blood was eliminated very rapidly by the urine, and when it existed in considerable quantities in the organism it did not, as generally supposed, undergo a rapid transformation into carbonate of ammonia. Dogs into which urea was injected, after the renal vessels were tied, to prevent the rapid elimination of the poison, showed no more marked convulsive symptoms than others in which the same ligature was made without the injection. The convulsive symptoms observed with urea were produced by an impure substance containing ammoniacal salts. The authors summed up in the following conclusions:-1. Pure urea, whether natural or artificial injected into the venous system in large quantities, never brings on convulsive symptoms; it is rapidly eliminated by the secretions. 2. There are no ferments in the normal blood which convert the urea into ammoniacal salts. The rapidity of elimination cannot be regarded as the cause of the non-conversion, for, by the suppression of the renal secretion the elimination of the urea may be retarded without accelerating the supervention of the eclampsia. The urea which in large doses brings on convulsions is always impure urea which contains ammoniacal salts, which are easily shown to be present by Nessler's reagent.Medical and Surg. Reporter.

Ligature of the Femoral Artery,—(Two cases of ligature of the femoral artery with carbolized catgut, by D. WALSHE, L.R.C.P., Edin., &c.)-Now, when the merits of catgut as a ligature are being discussed, it would be well if every practitioner who has ligatured an artery in its continuity would publish the case. Shonld arteries have been ligatured by men, who like myself, cannot boast much skill or experience, the cases would still be very important as proof of the success of any particular plan of treatment, or of the efficiency and safety of and particular kind of ligature. Of course they would not be so valuable if advanced as proofs of the failure of a plan of treatment, or of the inefficiency or danger of a ligature. The hope that the two following cases will be of some slight use is the only excuse I can make for reporting them.

CASE I.-James R, thirty-two, soldier, was admitted into the Chorlton Hospital, Withington, Manchester, on October 15th, 1873. He was suffering from an aneurism of the left popliteal artery, about the size of a hen's egg. He had served in India, and had contracted syphilis whilst in the army. He had no history of rheumatic fever, and had no disease of the heart. He was kept in bed, and had large doses of iodide of potassium. After a week of this treatment no beneficial change was observed in the aneurism. I then applied a pair of Skey's tourniquets over the artery in Scarpa's triangle. He was left to manage these himself, and instructed to screw them up alternately. The aneurism, however, continued to enlarge, and the pressure of the tourniquet being removed, the pulsation returned as strongly as when he was admitted. It was then decided to ligature the femoral artery. I placed a ligature on the artery in Scarpa's triangle on November 11th, 1873. The material used was catgut, obtained from Messrs. Wood, of Manchester, who guaranteed it to be the same as that used by Professor Lister. It was not applied under the spray. The wound was closed with ironwire sutures, and dressed with carbolic lotion. Complete union by the first intention followed, and the patient was perfectly cured on the tenth day after operation. Two hours after the operation there was no perceptible difference in the temperature

of the sound and diseased limbs. He left the hospital in January, 1874; but returned the following August with a rupture of the right femoral artery. A large quantity of blood had been effused, and he was in a very feeble condition. So weak was he that Dr. Law (my colleague), Dr. Mallet, and Mr. Jones, of the Children's Hospital, Manchester, who saw the case with me, advised that no operation should be undertaken. The patient, however, insisted that something should be done for him, and, finally, it was decided that amputation offered the best chance of success. I amputated in the middle of the upper third of the thigh; but he survived the operation only a few hours. After his death I had an opportunity of examining the left femoral, which had been tied. It was perfectly continuous, and slightly. thickened at the seat of the ligature, where it adhered for about a quarter of an inch to the sheath on the outside. The vein did not appear to have been at all disturbed. The artery was completely occluded both above and below the ligature.

CASE 2nd.-Edwin H, sixty-one, joiner, was admitted into the same hospital on August 28th, 1872. This patient had an eneurism of the left popliteal, about the size of the closed fist. For three weeks he was treated by iodide of potassium and rest— that is, a fortnight longer than in Case I. In all other respects, however, the two cases were treated exactly alike, the pressure by the tourniquets being continued over the same space of time in each case. I mention this because it appears to be the opinion of some authors that unless a speedy cure is effected by compression, it should not be continued. The material used in this case was carbolized catgut, without any other antiseptic treatment. The wound healed by the first intention, except where the incision ran through a small slough, produced by the tourniquets.

Remarks. The ligatures in these cases were tied tight enough to divide the inner and middle coats, and were secured by three knots. Mr. Holmes is, I believe, of opinion that the mortality from ligature after compression has failed is 10 per cent. greater than when the Hunterian operation is done at once. Does it make any difference where, and with what kind of

instrument the pressure is made? In these cases the pressure was made over that part of the artery which was afterwards ligatured, and was made with an instrument which scarcely a all interfered with the vessels which were to carry on the collateral circulation. I learn from Dr. Van Buren's address to the International Medical Congress at Philadelphia that Dr. Todd, of Dublin, was in the habit of preparing his cases for operation by employing compression, " in order that mortification of the limb might be prevented by allowing some progress to be made. in establishing the collateral circulation." The difference in temperature between the sound and diseased limbs, immediately after the operation, in both cases was remarkably slight, and not the least symptom of gangrene made its appearance in either case, although E. H- was over sixty years of age. This would lead one to suppose that the collateral circulation was to some extent established before the artery was tied.- The Lancet,

Removal of the Astragalus-for the relief of Congenital Talipes.) In the British Medical Journal of Nov. 2nd, M. LUND of Manchester Royal Infirmary, reports a case of the removal of the astragalus in an adult for relief of congenital talipes. The patient, a factory operative. aged 29 years, was the subject of equino varus of the right foot. No attempt had been made in early life to remedy the deformity. Two years ago the outer side of the foot began to ulcerate at several points, and these had become so painful as to prevent him following his work. M. Lund decided to remove the astragalus, which operation he successfully carried out under the antiseptic method. The tibialis anticus and the planter fossia had to be divided subcutaneously, this being rendered necessary consequence of the contraction and crumpling up of the foot. After the removal of the astragalus and the divisions of these contracted bands, the foot could be placed at right angles to the leg. The case progressed favourably. M. Lund exhibited a cast of the foot and leg; although not perfectly well, yet the patient has so far improved as to be capable of bringing the sole of the foot to the ground, which before the operation was an