effect of the cold so well that she voluntarily continued its use; and soon her symptoms began to improve, and she eventually got quite well.

CASE III.—Miss C—, suffering from acute abdominal congestion due to obstruction of the bowels of many days standing. Here the abdominal distension was great, the sickness frequent, and the tenderness considerable. In addition to opium at intervals, ice-bags were now substituted for warm poultices, aud the relief given by them was very decided. They were continued for many days at intervals, and under their use the sickness and abdominal distension markedly subsided. The patient was ultimately relieved by operation; but there could be no doubt of the palliative efficacy of the cold.

CASE IV. Mr D, suffering also from obstruction of the bowels. The symptoms were pain, sickness, constipation, and paroxysmal torminous convolutions of the bowels. Ice was freely applied in the same manner as before, and the relief was marked and continuous. This patient eventually rec vered from the obstruction, and the bowels acted again.

These cases are, I think, sufficient to show. that, in the local use of cold in abdominal inflammation, we have a remedy of great value in certain cases; and that, though of course, it is not applicable to all, and probably requires to be used tentatively in the great majority, yet that it is, when properly applied, both safe and reliable, and by no means to be regarded as precarious or as requiring "courage" for its application.

The forms of abdominal inflammation or congestion to which it is most suited are doubtless the more sthenic ones, in their early or middle stages, before collapse begins to show itself, and where accompanying circumstances are not of a depressing nature. But it has seemed to me that the patient is generally the best judge of its suitability, and that it may safely be left to his or her feelings to decide as to the propriety of its continuance. In some cases the influence exerted is certainly most grateful to the feelings.

Niemeyer and others advise that cold should be applied to

the abdomen by means of cold water compresses or cloths wetted in iced water. The plan of applying the cold by means of one or two bladders half filled with broken ice, which can be shifted from place to place, has seemed to me to be more satisfactory. I have usually directed that they should be removed as soon as they cease to be agreeable, generally in twenty or thirty minutes, and reapplied after an interval of an hour or so. I wish to say that the first case in which I saw the cold so applied was one in which its local use was advised by Sir W. Gull, and from him I derived my knowledge of this mode of its application. The injection of iced water into the rectum has been suggested, but of this I have no experience.

The modus operandi is, no doubt, to abstract heat, to benumb exalted sensibility, and to contract the dilated and semi-paralyzed vessels. And its especial effects have seemed to be, to diminish abdomial distension, to control the volvulous writhings of the bowels, and thereby to relieve both pain and tenderness. I can only add that very recent experience leads me to think that we have of late unduly neglected a valuable therapeutical agent, and I have therefore ventured to bring the subject before the notice of our Society to-day.—London Lancet.

PHOSPHORUS IN NERVOUS DISEASES.

By E. LEMAIRE.

After having devoted some pages to the history and physiological action of this drug, as well as to the pharmacology of the same, the author explains its principal therapeutical applications based upon 73 cases.

I. In paralysis subsequent upon acute diseases, and ataxoadynamic fevers, as well as hysterical paralysis and that from exposure to cold, phosphorus possesses no special action. The same may be said of paralysis the result of cerebral softening or a cerebral hemorrhage of a certain extent. But in a paralysis following a hæmorrhage of limited extent, and which has not produced too much disturbance in the nervous system, phosphorus seems to assist and hasten the cure, even when the

palsy has lasted for a considerable time, say, for example, a year. But that the drug may exhibit its full action, it is necessary that all congestive and inflammatory symptoms shall have disappeared. Then we must begin with a dose of grain and gradually increase to a larger quantity, never going beyond or of a grain.

In spinal paralysis, phosphorus is quite inert if the paraplegia be of very long standing and if it be connected with softening or advanced sclerosis of the cord.

II. In locomotor ataxia, the administration of phosphorus is sometimes followed by good results, inasmuch as it strengthens the patient, diminishes the inco-ordination of the movements, and seems to arrest the progress of the disease and keep it in a stationary condition for perhaps a long period.

It does not appear to have any beneficial action upon the lightning-like pains or upon the ocular disturbances of this disease; and it exerts a very varying influence upon the genitourinary organs, since it sometimes excites sexual desires, and at times has no effect of that kind at all.

Want of success of the phosphorus treatment seems to depend upon several circumstances; Ist. Duration of the complaint. 2nd. The existence of symptoms of congestion of the spinal centers or of an excessive irritability of the nervous system. 3d. The existence of gastro-intestinal troubles, diarrhoea or vomiting, in which cases phosphorus is contra-indicated.

III. Phosphorus has been employed in lead and mercurypoisoning, and in poisoning by the fumes of carbon sulphide. In lead poisoning it produces no effect, but in the two last it is often followed by very marked improvement.

IV. In paralysis of some of the ocular muscles, in incomplete amaurosis, in amblyopia not symptomatic of organic disease of the retina, in anaphrodisia, the results obtained are uncertain.

The author repeats that we must begin with a dose of gr. gradually increasing the dose to or grain which should be given in two separate portions, and during meal-time, because when fasting it gives rise to eructations of phosphorus odor

and is also more irritating. Besides, as this is a drug which is cumulative in the system, the treatment must be suspended at the end of ten or twelve days, to be recommenced some day subsequently. Revue des Sciences Medicales, 15 Jan. 1876.

LACTIC ACID AS A HYPNOTIC.

The London Medical Record states that at a meeting of the Berlin Medical Society, Dr. E. Mendel read a paper on this subject. Referring to the observations of Preyer and Luther Meyer on the hypnotic properties of Lactic acid, he said that its effects when administered by the mouth, either pure or in the form of lactate of soda, were uncertain, but he had found very good results from its use in enema in a large number of cases. The dose of lactic acid was from five to twenty grammes (seventy-five to three hundred grains,) mixed with an equal quantity of lactate of soda. The use of lactic acid was especially recommended.

1. In the case of insomnia in the course of or during convalescence from debilitating disease, after hemorrhages, etc; 2. As a Calmative in excitement of the insane; 3. As a remedy in certain psychoses, in regard to which its precise indications must be determined in the future.

In commencing a discussion on Mendel's paper, Dr. Senator said that he had used lactic acid either in divided doses, ten grammes (one hundred and fifty five grains) being given in the course of the day, or in single doses of from five to ten grammes in sugared water or as a lemonade. With the first named mode of administration no weariness was observed. On the other hand, a large single dose produced pure weariness although lactic acid could not be compared, as regarded strength or duration of action, with morphia or with chloral hydrate. There was however, a troublesome after-effect which had not been noticed by Mendel nor Luther Meyer, the occurrence of rheumatic pains; these he had observed twice, once in a phthisical patient, the other time in a man who had frequent attacks of muscular rheumatism. Rheumatic pains had also been absorbed in giving

lactic acid with other objects, such as the treatment of diabetes, &c. The occurrence of rheumatic pains after the administration of lactic acid was of importance with regard to the theory of articular rheumatism, and he asked whether Mendel or Meyer had observed anything of the kind, Mendel answered in the negative. The doses used by Senator were too small; at least fifteen grammes should be given. He agreed with Senator that lactic acid was inferior to morphia and chloral hydrate.-Medical and Surgical Reporter.

PAINLESS APPLICATION OF THE ACTUAL CAUTERY.

The surgeon is often deterred from using the actual cautery by the pain it produces. This pain may be avoided by the ap plication of carbolic acid. This local anesthetic is not used with near the frequency which its efficacy deserves.

Pure carbolic acid should be applied to the parts to be cauter ized which are then covered with a light compress; after a short time, before the anaesthetic effect has passed off, apply the cautery. There will be a complete absence of pain. It is immaterial whether the acid be liquid or crystallized; in the former case it is to be applied with a brush; in the latter it extends over the parts as it liquifies.—(Gazz. Med. Ital. Venete.-N. Y. Medical Journal.

HOW TO CURE A COLD IN THE HEAD.

The following formula has the authority of Dr. Ferrier as being a snuff which may be used to good advantage in acute catarrh of the nasal mucous membrane:

R

Hydro Chlorate of Morphia, grs. ij.
Acacia Powder, zij.

Trisnitrate of Bismuth, 3vj.