BY A. H. BUCKMASTER, M. D.

He

Dr. Galabin (Trans. Obstet. Soc. of London, Part II., March, April, and May, 1889), speaking of the difficulty of rendering the vagina aseptic, says: "We are told that a drop of normal mucus from the cervix of a woman at the end of pregnancy, when drawn with a sterilized platinum rod across nutrient jelly, may produce as many as two hundred colonies of different forms of bacteria. All who have tried to render the vagina aseptic, in the sense of being sterilized, for gynecological operations, will know how difficult this is to accomplish." quotes the researches of Steffeck, which show that no number of douches of perchloride of mercury will render the vagina aseptic at the end of pregnancy. To effect such a result, it is necessary to scrub vigorously with two fingers, not only the vagina, but the inside of the cervix, while a douche of at least a litre of the antiseptic is being used. Even this produces only a momentary effect, unless it is followed up afterward by the use of at least four or five douches at intervals.

The assumption from this is that these microbes may be regarded as innocuous.

A CASE OF TUBAL PREGNANCY TREATED BY THE INTERRUPTED GALVANIC

CURRENT.

Dr. George M. Edebohes (Med. Rec, Dec. 7, 1889) made the diagnosis of ectopic gestation for the following reasons:

Ist. Absence of menstruation for six weeks in a woman who was always regular, accompanied by slight morning sickness.

2d. The development and rapid steady growth of a tumor in the region of the tube, where it was positively known that nothing had previously existed.

3d. The accompanying of this development by metrorrhagia, laborlike pains, and the passage of shreds.

The case was seen by Dr. T. Gaillard Thomas, who agreed in the diagnosis, and the case was treated by the passage of a slowly inter rupted galvanic current, seventy-five milliamperes, applied ten minutes; six séances in all with about forty-eight hours interval. At the end of six months the mass has entirely disappeared and the patient has recovered from all unwelcome symptoms.

AN OPERATION FOR REMOVAL OF AN EXTRA-UTERINE PREGNANCY PREVIOUS

TO RUPTURE.

Dr. Theophilus Parvin (Annals of Gyn., Nov., 1889) reports a successful operation for the removal of the fruit sac previous to rupture. The patient, a multipara, menstruated on July 29th, and in the latter part of August and September she suffered from nausea, and believed herself pregnant. In September she had occasional violent attacks of pain low down on the left side, followed by soreness; some fragments of membrane had been discharged. A tumor was discovered adjacent to the somewhat enlarged uterus, on the left side. There was great sensitiveness to pressure in the lower part of the abdomen, on the left side. The gestation-cyst included in the tube was removed, and the patient made a good recovery.

[This case and the one preceding illustrate the two methods of treating this condition.]

CURE OF AMENORRHEA BY SHOCK.

Dr. E. T. Collins (Brit. Med. Journ., Oct. 26, 1889) reports the following case: M. M., single, aged thirty-five, healthy and robust girl, suddenly ceased to menstruate, two and a half years ago, without apparent cause. No suspicion or indication of pregnancy was present. She did not complain of any subjective symptoms, except monthly, when slight headache, backache, and malaise were felt for a few days. Medical treatment gave no results. Last June, returning in the evening from a country walk, she was suddenly alarmed by a tramp on the roadside. The catamenia commenced that evening, and has continued normal at the last three periods.

DISEASES OF THE SKIN.

BY SAMUEL SHERWELL, M. D.

Taking a general review of the past year, it must be conceded by all conversant with the subject, that never since dermatology has come to be studied and considered as a special branch of medicine, has there been such a record as during 1889.

Four large scientific bodies have met in as many different countries for the purpose of reading papers and interchange of views on matters dermatological, inclusive of syphilis and its manifestations. In order of time these were :

(1) The Germano-Austrian Dermatological Society's first meeting took place at Prague, June 10th and 12th, and was quite largely attended. A few foreign dermatologists were present, but most of these

were, as the name of the Society would warrant, of Austrian or German birth, etc.

(2) The Dermatologic Congress held in Paris, August 5th to 10th inclusive, next in point of time, but decidedly first, in order of importance. This was held under the auspices of the Exposition authorities, the lamented Ricord being named as President. All the distinguished dermatologists and syphilogues of France took part; a large number of English, German and Americans also in attendance. The total membership of those having an active interest was about 200.

(3) The American Dermatological Association held its thirteenth annual meeting this year at Boston, September 17th, 18th, 19th, which was numerously attended, and before which matters of great interest

came.

(4) The meeting of the section for dermatology of the "Society of German Naturalists and Physicians" was held in Heidelberg, September 18th to 20th inclusive. This was during the sixty-second meeting of the parent Society; but the first of the section; thus recognizing as it were the necessity of such. A well attended and interesting gathering.

The subjects taken up for consideration in most of these learned bodies have been often, of course, abstruse, and at first sight interesting only to the illuminati; but out of the divers opinions, and consequent clashing of such, great good may be expected, all tending finally to clarify and simplify the subjects; just as for instance in the matters of syphilis, one has only to go back, say thirty years, to see how many and various were the opinions on its manifestations and those of kindred diseases in the minds of men equally sincere and learned.

The length and duration and best methods of treatment of specific troubles, with a view to avoidance or cure of their dermatological lesions, were much written about and discussed at the meetings as given above; as were also leprosy, lupus, the distinctions of the lichen group, and that of pityriasis rubra and the general exfoliative diseases of the skin.

Much was done to conduce to the making of the approaching Congress at Berlin (1890) a success, in the matter of well-considered papers on these and other matters.

Philippe Ricord, October 22, 1889.-The necrology of the year is rendered illustrious by one name, "Ricord," who died on the above date full of age and honors. An eloquent tribute to his memory is given by Hans von Hebra, son of the famous professor of same name, in the Monatshefte für Practische Dermatologie, November 15th, 1889.

It will be a surprise to many to know that Ricord was by birth an American, being born in Baltimore in the year 1800, his parents having

been driven from France by the disturbances incident to the then Revolutionary period.

In 1820, returning to France, and settling in Paris, he became a student with "Dupuytren," having, however, later had some disagreement with him, he transferred his friendship and allegiance to "Lisfranc," to whom and "Didier" he dedicated his Thesis in 1826.

After a short sojourn in the provinces his ambition and ability enabled him to gain an hospital position in Paris again, and in 1831 he was given the service of syphilitic and venereal diseases, etc., in the Hôpital du Midi. He there began the series of observations on genitourinary diseases in general, which have immortalized him.

His first fight and victory was the differentiation between gonorrhæic infection and that of the specific sores of venereal origin. The time of absolute proof being shown, and accepted, was 1838, the series of innoculations described and practised by him affording it.

Again, later came the question of identity or duality of primary specific lesions. This was again answered by him by the same innoculation method in 1857 and shown to be undoubtedly dual in character, thus agreeing with and substantiating the opinion earlier formulated by "Bassereau" in 1852. In this matter his distinguished pupil, Fournier," shared the honors.

Again, another question came up: Could syphilis be contracted from any other lesion than a primary syphilitic chancre or accident, and its secretions? That this was the only method of propagation was long maintained by Ricord, and supported with all the ability he possessed; but "Gibert' and others in a report (1859) settled the matter decisively that secondary lesions, etc., might do so. Ricord's surrender was full, complete and generous.

Ricord never married; his mode of life, though for many years of the simplest, was in great measure altered by his ever-increasing fame. Kind, generous and charitable of the immense sums he must have received, little remained at his death.

All charitable institutions and works in Paris have to lament a benefactor. During the war of 1870-71 he was chief of the "Presse" Hospital and service, and the first in good and brave work.

In many special, and most general ways a friend to humanity is dead.

BY B. MEADE BOLTON, M. D.

THE FATE OF PATHOGENIC MICRO-ORGANISMS IN DEAD BODIES.

Dr. E. v. Esmarch (Zeitschrift f. Hygiene, Bd. 7, Heft 1) finds that there is a comparatively rapid disappearance of the pathogenic microorganism from the dead bodies of animals which have died of bacterial diseases. His experiments also show, where the dead bodies are placed in water or buried, that the water or earth surrounding them does not become infected. In the case of anthrax, substantiating the observations of Feser, he finds that the bacilli die out very rapidly from the dead bodies of the host.

That this disappearance is not due alone to the crowding out of the pathogenic bacteria, by the micro-organisms of putrefaction, is shown by preserving tissues, containing pathogenic bacteria from dead animals, aseptically. In this case the pathogenic organisms disappear; but it is true they remain present longer than where they are made to contend with the putrefactive bacteria.

E.'s conclusions, in accord with nearly all German observations, are that the proximity of cemeteries, and the drainage and ground water from the same, have no effect upon the spread of epidemic diseases.

CONCERNING THE EFFECT OF VENTILATION ON THE MICRO-ORGANISMS

SUSPENDED IN THE AIR.

Dr. Richard Stern (Zeitschrift f. Hygiene, Bd. 7, Heft 1) made his experiments in a room in which he could have perfectly quiet air, or a more or less complete ventilation. The openings in the walls of the room were so arranged that he could admit the air from without, either at the upper part near the ceiling and convey it off near the floor on the opposite side of the room (winter ventilation), or the air could be. admitted near the floor and conducted out on the opposite side of the room near the ceiling (summer ventilation). The rapidity of the ventilation was also under complete control.

The air of the room was intentionally loaded with micro-organisms. Pure cultures were mixed with the dust collected from school-rooms and factories, This was then dried and pulverized and blown about in the room. The air was then examined for the number of microorganisms, by Petri's method, at various times.