Editorial Abstracts and Selections.

PRACTICAL MEDICINE.

1. Experiments with Vaccine and Variolous Matter on Cows.The Boston Medical Journal contains an interesting article upon this subject, by Dr. Cutter, of Woburn, Mass. The object of the writer is to show, by fifty experiments performed on cows, that vaccina is not a form of variola, or cow-pox modified small-pox. This was inferred from the unsuccessful attempts to produce a normal vaccine pustule, by inoculation with fresh variolous matter; while upon the very same animals, by vaccination with the virus in ordinary use, the normal vaccine vesicle was always produced.

In the experiments instituted, three modes of introducing the variolous matter into the kine were made: 1. By quills, and puncture with lancet. 2. By rubbing the charged points of quills upon abrasions of the hairless cutis. 3. By introducing, in the form of setons, threads charged with the variolous virus.

The latter being the easiest, most expeditious, and most certain way of inoculating or vaccinating kine.

Vaccination on the cow was practised in the following ways: 1. By setons; that was tried twice, and was not successful. 2. By quills; these, if fresh, generally succeeded. 3. By pricking into abrasions of the cuticle with a lancet portions of a scab dissolved in water, until it is of the consistence of thick paste. This was uniformly successful.

Vaccine pustules were produced on the cow by vaccine virus from the human subject, as easily as on a child.

Dr. C. does not believe that the vaccine virus directly from the cow, is better than that which has been repeatedly transmitted through the human subject, and has not been, in his experience, more certain in producing the characteristic vesicles.

2. A Characteristic Sign of Typhoid Fever.-M. Sapolini describes a characteristic sign of typhoid fever, even when arriving at convalescence. It consists in a peculiar pulsation of the carotids. A large arterial wave occurs first in the artery, rapidly followed by a second less voluminous, then by a third, which is suc

ceeded by a moment of pause. This inequality, and the sensation of interrupted frémissement under the fingers, are very constant and easy to verify, according to M. Sapolini.- London Lancet, March 3, 1860.

3. Chloroform in Sleeplessness. Fonssagrives recommends (Bull. de Ther., lvi., p. 401) five to ten drops of chloroform, in mucilaginous mixture, in agrypny, when opiates are ineffectual or contraindicated.

4. Acupressure.

SURGICAL.

Attention having been lately called to this new method of arresting hæmorrhage, we were interested to learn that in the year 1853, Dr. J. M. Carnochan, of New York, employed it successfully in a case of hæmorrhage from a wound on the left side of the forehead, in a boy with the hæmorrhagic diathesis. The wound was received while playing, and extended about two inches upwards and backwards from the superciliary arch, complicating some of the anterior branches of the temporal artery, and detaching the scalp considerably from the cranium. After resorting to various modes of compression without success, Dr. Carnochan says, in the American Medical Gazette, that he"Selected two long suture-needles, slightly curved towards the point. Feeling with the forefinger of the left hand for the artery, where it passes over the zygoma in front of the ear, I dipped the point of the needle through the skin and other tissues, about three lines to the right of the course of the vessel, and carried on the needle below the artery, directing the point so as to emerge through the integuments, at a corresponding point on the left side of the vessel. This done, I made a figure-of-8 around the needle, in order to increase the compression already effected on the vessel by the position of the needle. The same procedure was carried out on the opposite side, in order to intercept the anastomosing circulation.

"The wound was now cleansed, and filled with dry lint; compresses were laid over the lint, and the dressing completed by the application of Barton's bandage.

"Entire success followed the compression of the artery thus effected by the needles. The patient rallied under the use of cordials and tonics; the needles were removed from the arteries on

the fourth day; the wound granulated and healed kindly, and in four weeks he was discharged as well."

Dr. C. further states that he recently "had an opportunity of applying this method to the arteries of a bleeding stump, after amputation, and with a very satisfactory result. The case was one requiring amputation of the right foot, at the tarso-metatarsal line of articulation. The operation was performed by making a semi-lunar flap on the dorsal aspect of the foot, a little in front of the tarsus. The flap was then dissected backward, and the dorsal and plantar articular ligaments, between the tarsal bones and the metatarsus, severed completely. The foot being held horizontally, the narrow knife was slipped under the tuberosities of the first and fifth metatarsal bones, and carried forward, grazing the lower surface of the metatarsal bones, so as to make a flap of sufficient extent to cover the exposed stump. The anterior tibial, external plantar, and internal plantar arteries bled freely, and three smaller vessels, also, afforded blood enough to require their obstruction. Regarding this as a favorable opportunity to test the effect of acupressure in amputation, to arrest the bleeding from the anterior tibial, the point of a steel shawl-pin, with a metallic head, and about four inches long, was passed slantingly to the depth of half an inch into the tissues, at about an inch and a half from the course of the artery on the side nearest; and having passed onward, was made to emerge about a line from the artery. The pin was next directed over the trunk of the vessel, about a quarter of an inch from the bleeding orifice, and again dipped into the tissues on the other side of the vessel, about a line distant from it. The pin was then still pushed through the tissues for about an inch and a half, and again made to emerge onward for an inch. The compression on the artery was complete, and it ceased to bleed. The external plantar artery was next treated in the same manner, and with a similar result, as well as the internal plantar and the other vessels which would have required the ligature. In these last-mentioned arteries, not having at hand acupressure needles of suitable length, short suture-pins were employed; tying a piece of thread to the head of each, in order that they might be pulled away at the proper time. securing the anterior tibial artery, it was not thought necessary to pass the pin through the integuments, as Professor Simpson

recommends. The flaps were now brought together by points of suture, and the long pins and threads attached to the shorter ones left between the lips of the line of union. The pins were removed on the seventh day. Since the operation, the patient has been most comfortable, and without the slightest evidence of secondary hæmorrhage."

Judging from the results obtained in the cases above related, Dr. C. expresses himself as having "no doubt that acupressure will become a distinct and established method for arresting hæmorrhage in operations; and that, although it may not supersede the use of the ligature, it will, in many instances, supplant its use, as being more simple and equally effective, and as less likely to interrupt the primary union of wounds."

He justly adds, in conclusion, that "the celebrated Edinburgh Professor merits the thanks of the profession for formulizing 'acupressure' into a distinct method."

5. Extraction of a Fragment of a Silver Catheter from the Bladder, by the Operation of Lithotomy.-Rev. Mr. J., while hastily performing on himself the operation of catheterism, which, on account of an old stricture, he is obliged daily to practice, broke the instrument within the urethra. As the catheter could not be felt in the course of the urethra, it was evident that the broken end had slipped into the bladder, and the operation of lithotomy for its removal was immediately determined upon.

This was the third accident of the kind which had happened to the same patient. On the first occasion, I removed the fragment from the urethra by perineal section. At the second similar accident, two months ago, the patient complained for a few hours of severe pain, but which then entirely subsiding, it was believed the piece, instead of receding into the bladder, had escaped unnoticed from the urethra, and fallen to the ground.

The catheters which were in such frequent use by the patient, had evidently become so attenuated by the oxidizing properties of the urine, that when roughly forced into the bladder, in the haste to relieve it, they were easily broken.

The operation performed for the extraction of the fragment was the lateral method, performed by cutting down on a staff in the usual manner. Through a small opening made in the prostrate

gland, forceps were introduced, and a body at once seized, which, on being drawn out, proved to be the piece of catheter lost in the bladder at the second accident, two months previously. It was blackened, and covered with dark, clotted blood. The piece, which had been the object of the operation, was with difficulty extracted, on account of the rough, broken end catching in the folds of the collapsed bladder. It was five inches in length.

The patient is now, six days after the operation, doing well, and I have ordered made for him a strong gold catheter, to insure him from another repetition of this dangerous accident.-Dr. JAMES ROBARTS, Carbondale, Ill., in Med. and Surg. Reporter.

OBSTETRICAL.

6. Cases and Reflections on the Use of the Gum Elastic Air Bag. -I was called to see a patient in consultation with Dr P., who was suffering with symptoms of impacted pelvis, caused by retroversion of the uterus, viz.: retention of urine and fæces, tenesmus of very distressing character, vomiting, irritative fever, great restlessness, etc. Her symptoms had been gradually increasing for three weeks, until they had become intolerable to her, and alarming to her friends and medical attendant. Two unsuccessful attempts had been made to replace the uterus. I found the pelvis literally crammed with that organ, pregnant nearly four months. There was hardly room to pass the finger up behind the symphisis pubis, and a little to one side. She complained of excruciating pain upon every touch, and declared she could not bear any manipulation for the rectification of the displaced organ.

We could not induce her to take a favorable position on the bed, and I operated while she was sitting on the lap of a female friend. I insinuated my fingers along the perineum, coccyx and hollow of the sacrum; gently, but firmly, pushing the tumid uterus upward and backward along the curve of the sacrum, far as I could reach. Holding it in this position, I introduced my colpeuryuter, empty, as far up along the sacrum as I could make it go, and held it there until Dr. P. inflated it. Air was driven into it, until it was the size of a large hen's egg. I then pressed it thus inflated, up high as I could reach, and again had more air thrown into it, until it had increased to nearly double the size after first inflation. Pressing it still upward and backward firmly