sheer ignorance, and that architects, highly educated professional men, from want of practical attention, have failed to detect the hidden causes which are silently operating in producing the most disastrous results. Sand is often dragged from the bed of the river too near to the sea or brought as ballast in ships from foreign ports, and being saturated with salt is unloaded into barges and sold to builders, who have every inducement to use seaborne sand, inasmuch as it makes beautiful white mortar, and may be mixed with lime in larger quantities than sand obtained inland. The soft Thames sand used in making bricks gives them a fine pale yellow surface; this kind of brick is pleasing to the eye, but if it be not "weathered" it renders the structure built of it open to all the defects which have already been stated. Owing to the fineness of the work it yields, architects often specify that all the outside work is to be done with Thames sand. The author points out further that the woodwork of buildings as well as the brickwork is constantly charged with saline matter when brought across the sea. Wood absorbs moisture rapidly. It first absorbs water in the course of its transit from its place of growth to its place of shipment; then it is exposed upon its sea-voyage to a further absorption of saline particles, and the author has often found timber unloaded from ships in the Commercial Docks and elsewhere nearly as wet before it was put into the water of the timber-basin as it would be after lying there in rafts. The timber thus brought over the sea is "well-pickled," and lying in fresh water does not abstract (we suppose in the time allowed) the whole of the saline matter it may have taken up. The author, we think, up to this point proves his case; he has shown that building materials charged with saline matter are in daily use, and he has further shown that buildings so constructed are of necessity damp buildings. But when he proceeds, as he afterwards does, to dwell on the "consequences," he proceeds beyond his knowledge. He opines that the "chronic rheumatism, ague, and intermittent fever" of our workhouses and many of our large hospitals originate from pervading damp; that the like obtains in the crowded dwellings of the poor; that the rich, whose residences wear a degree of splendour on their exterior, have "the same canker-worm of saline damp;" and that diseases are thus generated and matured when neither "medical men, family nurses, anxious parents, nor disconsolate children," ever dreamed of the agent that was creating the evil. In order to prevent the errors that he has pointed out, the author says it would be desirable, in so far as it can be done, to take all materials from the estate upon which the proposed buildings are to be erected. The bricks ought to be either slop made, or the mould sanded with the best quality of soft inland sand. The mortar should be made of lime mixed with inland sand, and to save sand a portion of burnt earth ground in a mortar-mill may be mixed with an equal quantity of sand. The mortar in all cases should be ground. If suitable stone can be obtained within a practicable distance, at an expense less than, or not exceeding that, of brick, it is preferable. We have given a faithful résumé of this short essay, and while we do not think the author has proved anything in respect to the production of disease, we admit he has given to our

profession a good practical hint. We are becoming, especially through the labours of Dr. George Buchanan, keenly alive as to the influence of damp in the production of phthisis pulmonalis, and we are glad to know any important fact in respect to the cause of permanent damp in our dwellings. Saline damp comes to us, therefore, as an idea charged with interest and deserving our closest observation. It is our business to ascertain if a statement so positively made be really true.

SUMMARY.

The Antagonistic Action of Opium and Belladonna. By J. T. NEWMAN, M.D. (Chicago Medical Journal,' November, 1867.)

Dr. Newman relates a case in which a woman who was an opiumeater, and who could take sixteen grains of morphia at once without injury, took a dose sufficiently excessive to produce coma, stertor, small pulse, contracted pupils, fixture of the jaws, and coldness of the extremities. She recovered after subcutaneous injection of nearly two grains of sulphate of atropia.

On the Melting and Subliming Temperatures of the principal Poisons, Organic and Inorganic. By WILLIAM A. GUY, M.B., F.R.S. (Reprint from the Pharmaceutical Journal,' February, 1868.)

A brief but very useful extract of the varied and most interesting communications of Dr. Guy on sublimation of poisons. Deserves publication as a distinct essay.

Case of Mental Derangement limited to a single Moral Sentiment, occurring periodically, that sentiment being in a perfectly normal condition during the intervals. By Professor SAMUEL JACKSON, M.D. (American Journal of the Medical Sciences,' April, 1868.) The case recorded by Professor Jackson establishes, he thinks, two facts-the first the independence of the moral sentiments in a manner similar to that of the mental faculties, as demonstated by the fact of a single moral sentiment being diseased for nearly four years; the second that in monomania there may be intermissions.

Researches on the Nature and Action of Indian and African ArrowPoisons. By HERMANN BEIGEL, M.D. (From the 'Journal of Anatomy and Physiology,' vol. ii.)

A very able paper, full of laborious experimental facts, and eminently suggestive.

On Adulteration of Sub-nitrate of Bismuth. By Prof. R. REDWOOD. (Pharmaceutical Journal,' August, 1868.)

Dr. Redwood in this communication shows that sub-nitrate of bismuth is adulterated with phosphate of lime. The fact had previously been pointed out by M. Roussin, who found in one case as much as twenty-eight per cent. in a sample which presented the usual appearance, and answered to the ordinary tests of sub-nitrate of bismuth. Roussin's process is as follows for the detection :-Dissolve equal quantities of the sub-nitrate and of tartaric acid slightly diluted with water, and add to this a strong solution of carbonate of potash until all effervescence has ceased and the liquid is rendered strongly

alkaline. If the sub-nitrate of bismuth be pure, the liquid will be clear and will remain so even after it has been boiled; but if the sample of sub-nitrate submitted to the test should contain phosphate of lime, even to the extent of but one or two per cent., this will form a white precipitate, which will not dissolve with long-continued boiling. To these remarks Dr. Redwood adds that the phosphate of lime, even when present in large quantity, is not precipitated in the first instance after the addition of the carbonate of potash, but its precipitation is immediately effected by boiling the solution. From one sample he obtained eleven per cent, and from another forty per cent. of this adulterant. He thinks both specimens were of foreign manufacture.

Indian Sanitation. (In the 'Public Health,' Nos. 5 and 6.) An able article, doing credit to the new and useful publication in which it appears.

On Sewerage, with Remarks on the Best Means of House Drainage. By C. B. NANKIVELL, M.D.

In this address, published at the request of the Torquay Medical Society, Dr. Nankivell maintains the health side of the sewage question in preference to the mere question of utilisation.

Change of Molecular Structure during Cadaveric Decomposition. By C. ROBIN. (La France Médicale,' October, 1867.)

M. Robin has conducted a series of researches on the change which takes place in the anatomic elements of the tissues after death. He has traced the changes from the first or progressive step to complete putrefaction, and states that when putrefaction is accomplished the tissues are reduced to a condition of molecular granulation, the granules being very minute, numerous, grey in colour, and having very active movement. The phenomenon of granular change does not appear until, by the smell, the substance is distinctly proved to have undergone putrefaction. Any partially solidified elementary homogeneous substances, fibres, or cells, if they do not present granulations at first, are ultimately resolved into the granular form, the change being complete throughout the whole of the structure.

Labour during Sleep. By WENDELL CASE, M.D. (The American Journal of the Medical Sciences,' January, 1868.)

The question whether labour can occur during ordinary sleep without disturbing the mother has been answered affirmatively by Dr. Case. He relates that in the evening of December 16th, 1860, he was summoned to visit Mrs. B-, a lady from France, residing in the town of Hopedale, six miles from his residence. She was twenty-one years old, and was near the period of her confinement, but attributed her symptoms to over-fatigue on the previous day. Dr. Case found there had been severe pains in the lumbar region and slight nausea. The os uteri was dilated to three fourths the size of a half-dollar. At ten o'clock Dr. Case, having waited an hour for return of pains, suggested that they should all retire to rest, and that he should be called, if required. About 4 a.m. the husband of the lady, in great fright, summoned him, exclaiming, "Monsieur le Médecin, il y a quelquechose

entre les jambes de ma femme;" and to his (Dr. Case's) great surprise, he found the head of the child had been wholly expelled during the profound sleep of the mother. In a moment the lady was delivered, and in less than twenty minutes the secundines were expelled. The patient said she had dreamed something was the matter with her, and awoke with a fright, probably the instant the head was expelled. She has since been confined, and with the usual amount of labour-pains.

REPORT ON SURGERY.

BY JOHN CHATTO, M.R.C.S.E.

Treatment of Secondary Syphilis by the Hypodermic Injection of Corrosive Sublimate.-Dr. Lewin, after disposing of the non-mercurial treatment of syphilis as little better than a crotchet, proceeds to show that, of all means of employing mercury, that illustrated in this paper is the best. He has employed it for more than two years at the Berlin Charité; and both he, his colleagues, and his patients, are satisfied with the results. The cases here referred to amount to 500, viz. 356 women and 144 men, the symptoms in all being thoroughly well characterised. The details are minutely tabulated, so that the various facts, such as prior treatment and its nature, the absence of this, the occurrence of relapse, &c., are duly set forth and easily referred to. Dr. Lewin employs Luer's syringe, or in some cases a larger one, and, owing to the corrosive nature of the fluid, insists upon its being constantly washed out, and its point frequently sharpened. In private practice he keeps a marked canula for each patient. He prefers the back, lateral thoracic region, or buttock, as the place of puncture, because less irritative inflammation ensues; but in iritis the temporal region is preferable. In the great bulk of the cases a solution of 4 grains to the ounce was employed, which, supposing the syringe to hold 15 grains, would give grain each time. In the very sensitive, from to grain of morphia may be added with glycerine. The injections are best performed in the forenoon and afternoon, and, if a very rapid cure is sought, again in the evening. The patient need not be confined to his bed, or in warm weather even to the house, care being taken that he is not exposed to chills. Even when this precaution has been neglected ill results have seldom followed. The diet need not be much restricted, beyond being somewhat diminished in quantity; but alcoholic drinks should only be taken exceptionally. Great care should be taken in keeping the mouth clean, but moderate smoking may be allowed. The pain caused by the injection is sometimes considerable, especially if it be not performed adroitly, or the patient is very sensitive. In general, he soon becomes accustomed to it. The subsequent irritation, which usually soon subsides, sometimes goes on to inflammation, induration, or suppuration, especially if the injection be too strong or too freely used, some patients being far

more susceptible than others. Dr. Lewin, in cases of slight venous hæmorrhage that have occurred among his many hundred injections, has never met with an instance of ill consequences supposed to be due to the introduction of the injected substances into the circulation. He found in his 144 male cases that the average quantity of 23 grains of sublimate were required to effect a cure, while in those of the cases which had previously undergone no other treatment 3 grs. were required. In the 356 women 24 grains sufficed, i. e. less than in the men.

Summing up his opinions, Dr. Lewin states that preference should be given to this mode, because (1) of the rapidity with which the symptoms disappear, this holding an exact proportion to the quantity of sublimate daily injected. Thus, two or three injections per diem of to grain cured numerous cases of iritis in from five to seven days. In these cases of very rapid cure the patient must keep indoors, and avoid all bodily or mental excitement. (2) The results, also, are certain and precise. In and out the hospital, the author during two years and a half has treated 900 cases, exhibiting every variety of symptom and group of symptoms; and in almost all of these, even in desperate cases, many of which had been fruitlessly treated by other modes, he has met with the most gratifying results. Syphilitic disease of the bones has offered the greatest resistance, for, although the nocturnal pains have been relieved, and the subperiosteal deposits removed, yet the bones themselves did not recover their normal volume. (3) The relapses are small in number and slight in character. The statistical comparison of the results obtained by this and by other means shows that while the relapses after the latter amounted to 81 per cent., those following the injection method were only 31 per cent. (4) Finally, the great convenience of the method, both for the patient and the surgeon.-Annalen des CharitéKrankenhauses, Band xiv.

Injuries of the Elbow.-Professor Bigelow observes that there is no class of injuries which so frequently gives rise to discontent and litigation, and these cases often turn out much less satisfactorily than they would have done had certain simple rules of treatment been adhered to. "The rule I would enjoin upon you is the following:-Ascertain first if the olecranon is broken, as this injury requires a special treatment. In all the other injuries, whether you are able to make an exact diagnosis, or are wholly unable to do so on account of the swelling, treat them as though the forearm had been dislocated backwards, and secure the arm at right angles to an inside angular splint. The propriety of this measure will not be doubted with regard to the more common dislocations of the arm. The very rare instances of the radius dislocated forwards, or the all but impossible dislocation of the ulna forwards alone, would doubtless declare themselves, and the bones would be replaced during the manipulation. Practically speaking, they are so rare that they need not be taken into account. But among the fractures, the transverse fracture of the lower end of the humerus, the T fracture into the