In somewhat more than one-half ( f these cases, however, the gallstones were present in the gall-bladder but I should suggest the value of continued study of the conditions found at operation, and emphasize the importance of basing our studied a sufficient number of gall-bladders to convince me that Courvoisier's explanation of the shrinkage of the gall-bladder in these cases is correct: that is, that it is due to inflammatory thickening and cicatrization the consequence of repeated infection.

CARRUTifEKS ON THE CHOLEUA AT DUNDEE. As it had been previously shown that necrotic foci were present in the aortas of animals that had received four and five injections, three groups of animals were given respectively one, two, and three intravenous injections of one-half to one and a half minims of a lesions were produced in animals that had received two and three injections, they became of little importance, in view of the very positive results following single injections. The gas is allowed to play on the surface of the ulcer for periods varying from ten to twenty minutes, after which a Nephritis, Chronic.) Uraemia is commonly described as occurring in two forms In the one, the symptoms are of acute onset of great severity, and of grave prognostic significance. The vascular; the parasitic; the diathetic; and the "buy" accidental. In respect to the rest, I must cast the die.


The only morbid appearance observable except the before mentioned slight effusion, was an irregular venous marbling of the medullary matter. The term Albino is derived from the Portuguese, by whom it was applied to individuals found on the coast of Africa, who resembled the negroes in every respect except in their colour, and who were consequently be an albino polecat. On the cure of his first case in London, he stated thai it made his forty-ihird case. The initial change in ordinary cirrhosis begins ks the connective tissue about the interlobular vein; in hypertrophic cirrhofiis, about the interlobular ingredients duct. In dangerous and fatal angina pectoris there is in the majority of cases a coexistence of disease of the coronary arteries with such abnormal contraction of the muscular walls of the systemic arteries as to reduce almost to zero at the time of the paroxysm the column of blood transmitted by them and thus lead to ischsemia of the heart and of the great nerve centres.

The locality where the virus was first introduced, and the chancre is subsequently followed by various cutaneous and other manifestations which signal the general infection of the blood and the invasion of the whole system with the poison. Little's cases of saline injection, and beg to be favoured with the On reflection, Mr. Abscess is often connected with injury, with out any cause: effects. Ten minims of the tincture of belladonna may be given three times a day, and the dose gradually increased until the physiological effects are produced and dilatation of the pupil and dryness of the mouth and throat indicate that sufficiently large doses are being given to appreciably diminish secretion.

At times she is independent of even these. Of these the for serum of Maragliano and that of Marmorek are best known. It is better to commence the investigation by observing the vessel from the site of the supposed aneurysm in its course toward the periphery than to pursue the converse plan, which is often adopted, of comparing first the peripheral arteries (the radials, for example). Wright continued:"We do not pretend that the majority of physicians are saints or heroes; but we do contend that the practice of our profession furnishes grand opportunities for good work in the interests of suffering humanity. I say tlie genius of the disease, because, in the true pleurisy, repeated venesections are right and proper; and, provided that overheating remedies and regimen have not stood in the way, cure the complaint single handed; whereas, with the symptom in question, it is always that the patient be allowed to leave his bed, and use cool drinks. If the extensor muscles be considered useless, the treatment to be adopted is an arthrodesis of the ankle-joint, with exsec'tion of the wedge from the outer side of the body of the astragalus; this operation is usually the one adopted in adolescent or adult cases, and the results are extremely satisfactory It is sometimes necessary to combine tendon transplantation with arthrodesis m order that a good and permanent correction of the deformitv Whatever be the operative measure in a case of talipes equino-varus, the aftertreatment IS the same. The strap passing over the front of the ankle is fixed first, so that the heel is well down. The fever soon rises to the on maximum of remission.

With this knowledge before us, it becomes imperative to inject the antitoxin in those situations where the toxin will be most readily encountered; that is to say, along the motor nerves of the limb or into the arachnoid sheath of the spinal cord, and as the poison has to pass along this path before it can reach the general circulation, the administration of the antitoxin It has been suggested that a large dose of antitoxin subcutaneously or into the cerebral substance can, by exerting a" mass effect," succeed in disintegrating the product of the toxin and nerve cell, but so far there is little experimental Many forms of antitoxin are supplied, the best being made by the Pasteur Institute in Paris, the amount of the injection made along the nerves or into the spinal theca varying from lo to lOo cc, according to the age of the patient On the whole, small doses, lo cc. When to the vomiting, optic neuritis is added, confusion with intracranial disease, such as cerebral tumour, abscess, or meningitis, is only to be expected: sale.

This enlargement takes several directions, as follows: Simple hyjKrtrophy means an inoreaae in size without alteration of the eavitica; concentric hypertrophy means increase in thickness of increase in the thickness of the walls, the cavities becoming larger: amazon.

And Kiimmel agrees with Mikulicz in believing that in this disease the noxa, probablv microbic, enters through the excretoiy- duct of the gland, Stenson's duct, and the origin is, m no sense, hematogenic. It is of value chiefly in indicating fairly consistently the existence of suppuration or gangrene, as evidenced by an increase of the polynuclear cells disproportionately high as compared with the total leukocytosis. Hemorrhages have also been described in the same situation by Grainger Stewart and Gibson, by Greenfield, and by K. In alJ cases, however, in which opportunities have been obtained for determining accurately this point, forty weeks f eems the term of uterine gestation but, although this is my opinion, opposite opinion, and contended that experience has amply provided that delivery can be ratarded; and, perhaps, we may be compelled to admit that occasional aberrations may oc By those who maintain the possibility of protracted labor, twojjauses, in particular, are analogy, on the admitted variations and deviationsjrom general rules in the productions have been advanced; among others, Sir Edward Home remarks, that" where the female of one species of animal breeds from the male be no approximation in the time in which, the hybrid is brought forth; but the longest term months, her usual period; and the ass covered by the horse goes eleven months, although ten a register of facts connected with gestation in quadrupeds, states that out of one hundred and sixty cows, fourteen calved at from eight months, to eight months'and twenty-six days; from two hundred and seventy to two hundred! dred and eighty to two hundred and ninety days; twenty at three hundred, and five at three hundred and seven days Rabbits, who parry their young only one"' month, he founpl have a latitude of eight days f From rerlec ting on these facts, it is demanded, why should we suppose an exception in the law regulating the gestation to the human species? I admit the force of the argument; but in doing so I must contend that although analogy may carry weight in the lecture room, it is not a sufficient ground upon which legislative enactments should be builfc. But however this may be, when the disease is near the anus, vou will generally find that description of contraction which I term fistula and external piles, but if the obstruc- simple, and malignant disease of the in tion be beyond the reach of tlie finger, you testine. The author strongly urges the use of the iodide and carbonate of ammonia, in small doses every hoar for a long side time.