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examples of spermatorrhoea. The patient drew up the details of his case himself.

Physical Condition.-Pain and burning, insupportable itching and tickling at the left side of the base of the cranium; the symptoms extending to the back and arm-pit of the same side; pains in the joints of the arms and legs; respiration difficult, oppressive; digestion painful; urine loaded; complexion yellow, earthy; eyes yellow, surrounded by a black circle; expression fixed; expectoration null; nasal secretion suppressed; pimples on the face, which is sometimes bloated, and sometimes extremely thin; limbs dragging; mouth pasty; loss of taste; numerous involuntary pollutions during sleep; and, lastly, general debility. The patient thought afterwards that he had cured. himself of the pollutions by taking camphor in the morning fasting. The moral state was still more afflicting. A vague feeling of general suffering, experienced by the mind and soul more than by the body; profound sadness; utter depression; incapability to laugh or cry; avoidance of all society; desire for solitude; restlessness; agitated nights; insomnia; incubus; hallucinations; always discontented, never even a ray of pleasure; incapable of the least work, or at least of finishing that which had been begun; excessive slowness in the execution of all things; more or less loss of memory, and great idleness; in fine, taciturn and a dreamer, the patient passed all his time in pulling out the hair of his head and whiskers; and, a burden to himself, and doubtless to others, he constantly entertained the idea of suicide, which he was prevented carrying into effect by a religious feeling,

Bleedings, salt-water baths, travelling, magnetism, hydrotherapeia, and a host of nervous medicines, were tried in this case, but uselessly. Wearied by all this, the patient determined to treat himself. He commenced by taking an emeto-cathartic, which acted well; a brisk purgative was then had recourse to for several days, and afterwards a milder one substituted, until it was no longer needed, the cathartic being again employed when circumstances indicated the necessity. Depuratives, and bran and gelatine baths, at the temperature of from 72° to 74° F. were next used, with exercise on foot and horseback; music, both vocal and instrumental; abstinence from all spirituous liquors, pure, and especially white wine, coffee, tea, salted or highlyspiced meats, and, in fact, everything that might irritate the nerves. A mild regimen was observed; and all excesses avoided. This plan was pursued for six months, and now the patient says he enjoys excellent health, sleeps for six hours at a time; rises as soon as he wakes; and is as fresh and happy now as he was sad and depressed six months ago. He has regained the integrity of his intellect, and can hear and understand well; and his memory is excellent.

THE ORGANIZATION OF LABOUR FOR THE INSANE.-M. Parchappe observes, that if the utility of labour in lunatic asyla were confined to its curative influence, its importance would be greatly diminished, for the patients who are really curable constitute but a very small proportion of the population of these establishments. But labour is in lunatic asyla, as in all large collections of men, an essential condition for the maintenance of order, and the preservation of good conduct. The well being of incurable patients even is not less intimately connected than that of other men with the laws of labour, whether it be considered as an hygienic measure for the preservation of health, by the maintenance of the equilibrum of the strength, or as a moral power capable of keeping the mind at peace, by the removal of sorrow and ennui.

It is evident, therefore, that as the greater number of insane patients in asyla are incurable, and as the latter only can be engaged in continuous labour, and that for a long time, it becomes important, in the organization of such labour, that it be adapted to the condition and wants of the incurables. In the first place, the occupations should be healthy, agreeable, and productive. In point of salubrity those occupations which bring all the muscles into action, and which necessitate exercise in the open air, are those which should be preferred. Sedentary occupations, which alone are adapted for a great number of women, can hardly be considered healthy, unless interrupted from time to time by intervals of sufficient length, during which exercise may be freely taken in the open air. They should be pursued in large well-lighted and wellventilated rooms, free from the extremes of heat and of cold. Labour may be made attractive, by varying the occupation, by changing the place where it is carried on, and by the satisfaction experienced by the creation of the products, and still more by the predilection for an occupation which the patient may have chosen, and to which he is habituated. It is therefore important, in allotting work for incurable patients, to select such as may the nearest resemble their employments before they were admitted into the asylum. The productiveness of the labour will be regulated by the wants of the asylum. The first step in this respect would be the supply of the asylum itself with whatever may be required by the work of the lunatics, and thus render it independent of out-door labour. Should there not be sufficient occupation thus afforded, other work may be given, regulated according to the predominating character of the industry of the country. Thus, in the asylum at Ghent, the fabrication of lace by the female patients is recommended, and the culture of silk-worms in the South of France.— Annales Medico-Psychologiques.

SELECTIONS.

ACTITE TUBERCULAR MENINGITIS IN THE ADULT.-M. Levy, principal phracian in the hospital Val de Grace, has reported three cases of this disease. In the first, the uberenlar affection of the pia mater was conpileated by softening of the brain, tubercles in the mesenteric and bronchial gands. pneumonia, with pulmonary apoplexy, tubercular percartitis. The patient was twenty-six years of age. In the second case, besides the tubercular disease, there were, meningitis, softening of the brain, and tubercles in the lungs, kidneys, liver, and several other organs. The thiri case was an example of tubercular meningitis, de veloped as a sequence of measles, accompanied by chronic pleurisy, and preceded doubtless by numerous tubercles on the lungs, and the general tubercular fathesis.-Bulletin de l'Académie Nationale de Médecine.

COMPLETE PARAPLEGIA CURED BY COLD BATHING AND URTICATION, -Dr. Van Bangevem has published, in the Annales de la Societé de Midecine d'Anvers, the particulars of a case of paraplegia, complete as to sensation and motion, occurring in a scrofulous subject, from constant exposure to the vicissitudes of the weather. Frictions with camphorated spirit, blisters, and purgatives, were tried for five weeks, but having altogether failed, Dr. Van Baugevem caused his patient to be plunged every evening up to the middle in cold water, dry friction with flannel being practised afterwards, for half an hour, and then urtication. At the end of a fortnight there was considerable improvement; the flogging with nettles was then omitted, the cold bathing and the frictions with flannel only being persisted in. Three months afterwards the cure was complete.

CHLOROFORM IN TETANUS-A young man of good constitution was admitted into the hospital, under M. Forget, labouring under acute idiopathic tetanus, the result of exposure to cold, while perspiring freely. The symptoms he presented, on admission, were those of incomplete trismus and opisthotonos. Bleeding and the internal exhibition of ammonia were at first tried, but without benefit. M. Forget then determined to have recourse to chloroform, four scruples of which, poured on a compress, were applied to the nose and mouth of the patient. From the increase of the general spasms, the moaning, the convulsive contractions of the respiratory muscles, and the turgescence and lividity of the face, it was feared that asphyxia was impending; the pulse, however, remained firm at 86, the respiration became stertorous, the foam which filled the mouth was cleared away, and the compress re-applied; all of a sudden the muscles became relaxed, the abdomen supple, the limbs fell lifeless, as it were, the relaxation and insensibility became complete, the colour returned, the stertor ceased, and a deep

calm sleep supervened. The application of chloroform lasted from one to two minutes; the sleep continued about ten. The tetanic symptoms returned when he awoke. With the view of breaking the chain of morbid habit, it was determined to re-apply the chloroform, but only twice a day, fearing that if more frequently used, disease might be lighted up in the lungs. The same effects were constantly produced by the anæsthetic agent, the period of excitement, however, diminishing in duration, and that of collapse occurring more or less quickly. M. Forget mentions particularly the occurrence of well-marked divergent strabismus, as an indication that muscular relaxation was taking place. Under this medication, the disease slowly but surely amended; after the lapse of seventeen days from the first use of the chloroform, and thirtyfour from the commencement of the disease, all tetanic symptoms had disappeared, and the patient was able to walk about-in fact, was quite convalescent. The strabismus mentioned as an indication of approaching muscular relaxation, it appears, was a condition of the rectus muscle of the eye, prior to the invasion of the disease; the squint, however, disappearing during the muscular contractions incident to the complaint.-Bulletin Général de Thérapeutique.

MELANCHOLY CURED BY SEVERE BODILY INJURIES.-Dr. Labruyère narrates the case of a man, thirty years of age, who had been subject to melancholia (délire melancholique) for several years, and who was severely wounded by machinery, either accidentally or otherwise. He had extensive wounds of the face and cranium, the bones of the latter being broken, and the brain partially exposed; the forearm was also torn off. The treatment was necessarily protracted, but as cicatrization made progress, the complete cessation of the mental disease occurred. Journal des Connaissances Medico-Chirurgicales.

MUSK AND BLISTERS IN ACUTE HYDROCEPHALUS.-M. Legroux, a physician practising at Beaujon, states that he has derived great benefit from the repetition of blisters and the exhibition of musk in the treatment of acute affections of the brain, when the following symptoms are present: coma, dilatation of the pupils, convulsive movements, and more or less extensive paralysis. He narrates cases in illustration of his opinion, and considers that musk acts by lowering the pulse, and the temperature of the skin, and by causing a velvety feel and relaxation of the integuments. In one case it acted as a sudorific. He considers musk to be a cardiaco-vascular hyposthenic, and perhaps also an hyposthenic of the nervous system.-Bulletin Général de Thérapeutique.

MERCURIAL FRICTIONS IN ENCEPHALITIS.-Dr. Privat, of Campagnae, employs mercurial frictions in the commencement of encephalitis, and when the inflammatory state is decreasing, but not when the disease is fully developed. Mercury is, he says, a powerful sedative of the nervous system, in cases of irritation and phlogosis, and a special excitant of the exhalent and absorbent system. - Bulletin Général de Thérapeutique.

INTERMITTENT CEPHALEA CAUSED BY AN EFFUSION OF BLOOD BETWEEN THE DURA MATER AND ITS PARIETAL ARACHNOID.-M; Dubois, of Neufchatel, was called to see a powerful robust man, fiftyseven years of age, who complained of gastric disorder and intense cephalea, caused apparently by grief for the loss of his child. The headaches, which were very intense, proved to be intermittent. He survived about six weeks, dying comatose. The head was examined thirty hours after death. On the removal of the upper part of the cranium, a considerable effusion of a black liquid was discovered over the right hemisphere under the dura mater, or rather, the dura mater properly so called, and its parietal arachnoid layer. The cavity, which contained about half a glassful of the liquid, was of an oval shape. There was not any clot. The cerebral substance was not apparently altered, neither softened, nor injected, nor adherent to the pia mater, nor to the internal layer of the arachnoid, nor was the arachnoid sac thickened in any way, but smooth and shining, except at the adherences of the falx. A small effusion of coagulated blood, extending transversely, was found in the lower third of the vertical thickness of the tuber annulare. M. Dubois attributes the intermittent cephalea to the hemispheric effusion, and the final attack of coma to the collection of blood found in the tuber annulare. Bulletin Général de Thera

peutique.

ALDEHIDE.-M. Poggiale, professor of chemistry at Val de Grâce, states that the inhalation of the vapour of aldehide is rapidly followed by the most complete insensibility; its stupefying action is more rapid and more energetic than that of ether and chloroform. Its odour is very powerful, or otherwise it would be preferable to chloroform in an economic point of view. A very considerable quantity may be obtained by a simple operation; all that is requisite is to distil a mixture of sulphuric ether, water, alcohol, and peroxide of manganese, and to rectify the condensed liquid with chlorine of calcium. Aldehide thus prepared boils at the temperature of from 82 to 84 Fahrenheit, and contains very little alcohol and formic ether. Perfectly pure aldehide is not necessary.-Académie des Sciences.

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