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tumble " fight a man received a wound in the left in- guinal region just above Poupart's ligament. .After re- ceiving the wound he mounted a horse, rode one mile, put up his horse, and then walked another mile to a friend's house. " When I saw him,' writes Dr. Ward, "he was very much exhausted. 1 found the outer open- ing about two inches in length, and the inner, penetrating the abdominal walls to the cavity, about one inch. Sev- eral folds of intestine with omentum protruded, and they were only returned after anx>sthetizing the patient. I first closed the inner opening with interrupted sutures, including the /c/'//'Aygestin Tablets of the remedy he was found at the breakfast- table. Dr. Douglas would agree with the author on most points, but there were a few to which he must take ex- ception. He would agree with him, for example, that quinsy was a manifestation of rheumatism, or, especially, of gout, and the treatment which he had employed for this affection was Aygestin 5 Mg largely that used by the President, namely, bicarbonate of soda. At the same time he gave the ordinary remedies against gout. He had found the gargle and spray of bicarbonate of soda also useful in cases of enlarged tonsil, but one of the most beneficial remedies for this class of cases was a powder composed of one part of menthol to a hundred parts of sugar of milk. He would not always resort to the knife for the removal of the enlarged tonsil ; it could be slowly, but surely reduced in size by the persistent use of a powder composed of salt, camphor, ammonia, and sugar of milk. Dr. F. H. Hamilton was inclined to agree with Dr. Bosworth that the enlarged tonsil should be removed by the knife ; yet he had often observed that the enlarged tonsil of childhood disappeared before the twentieth year. He supposed the author, when he said there was no danger connected with the operation, meant not in the acute or engorged stage, and not in those of the hemorrhagic diathesis. The question had been raised whether all or only a part of the tonsil should be removed : he should say all that the knife would include. Dr. Aygestin Cost Jacobi believed that the only efficient treatment I'or the enlarged tonsil was removal ; applications would not reduce its size, and where they had apparently done so the reduction was due to some other cause. The en- larged tonsil might remain stationary and ajipear smaller after the lapse of years, because of the growth of the fauces. As to the danger of hemorrhage, there usually was but little loss of blood, but it Generic Aygestin might be profuse from cutting into the soft (lalate — an accident which could not always be avoided. The most efficient means for stopping hemorrhage when it occurred Buy Aygestin was digital com- pression, applied, perhaps, for an hour or more. He coidd not agree with the author's view that follicular ton- sillitis was an essential fever ; he looked upon it as a local disease. What Dr. Bosworth took to be an essen- tial fever was probably diphtheria, for cases of diphtheria were often overlooked or mistaken for some other affec- tion. It was a great mistake to suppose that every pa- tient sick with diphtheria must necessarily die ; there were many mild cases which went unrecognized, and which were all the more dangerous for that reason, as (hey were the more likely to spread the disease. Dr. Jacobi laid particular stress upon this point because of its importance to the public health. Dr. Weder had not yet seen a case which Aygestin 5mg went to 4i6 THE MEDICAL RECORD. [October ii, i! substantiate the view that a phlegmonous intlanimation around the tonsils was due to the gouty habit. He had found it most frequently in patients of poor general health. The President remarked that guaiacum had once been strongly recommended in the treatment of quinsy, on account of the supposed gouty origin of the affection ; but he had not obtained the results with it which he had been led to anticipate from reading certain articles in the medical journals. Dr. Post thought the best treatment for the enlarged tonsil was extirpation. Dr. Hamilton had found the external application of ice or snow the best means for checking hemorrhage after removal of the tonsil. Dr. Fruitnight had aborted some cases of quinsy by the administration of the tincture of aconite. Dr. Jarvis again called attention to a distinction which he had made between the soft and hard, or in- durated enlarged tonsil, the latter being found in the syphilitic. If the scirrhous tonsil were cut it would surely give rise to hemorrhage, and might result fatally. He employed the knife in the removal of the soft enlarged tonsil, and the cautery or snare in the removal of the in- durated tonsil. He did not think any more of the tonsil should be removed thun was necessary, for it doubtless served some physiological purpose, as the lubricating of the fauces and protecting the carotid artery. Dr. Brandeis said he believed in the Darwinian theory of the survival of the fittest : the tonsils had sur- vived some thousand years, had fulfilled some physio- logical purpose, and he doubted not that they performed their function well, whatever it might be. But the ton- sils, like other structures, were liable to disease, and diseased tonsils might be worse than no tonsils at all, and therefore he believed they should in proper cases be extirpated. He then pointed out the advantages of the tonsillitome over the knife in certain cases. Contrary to the experience of Dr. Bosworth, he had found hemorrhage in young subjects rather than in tlie adult, although not extreme. To prevent hemorrhage, he allowed the pa- tient to sip a solution of tannic acid, and if necessary, he applied pressure. Dr. Bosworth's description of quinsy corresponded with that in Ziemssen's " Encyclopsedia," there called peritonsillitis, but Dr. Brandeis could not ac- cept the view that it was always an inflammation of the peritonsular sheath. He recommended aconite and the ammoniated tincture of guaiacum in its treatment until an abscess sliould have formed. Dr. Corning had arrested a severe hemorrhage after tonsillotomy in one case by the use of his carotid com- pressor. Dr. Bosworth, in closing the discussion, said, with regard to the possibility of reducing the size of the ton- sils by astringents, that he believed it could not be done. Their size, however, might be reduced in the young, in whom they were in a state of chronic inflammation, by the new tissue undergoing contracture. This would ac- count for the diminished size of the tonsils on reaching adult life. As to hemorrhage in the young, it was only an oozing ; considerable hemorrhage only occurred in the adult. That tonsillotomy was not dangerous was apparent from the fact that in all medical literature not a single fatal case was recorded. The cases in which the carotid artery had been wounded were excepted ; this accident could never occur in the hands of a surgeon. In arresting hemorrhage with the actual cautery, the iron should be applied from above downward, that it might not be cooled by the flow of blood before coming in con- tact with the bleeding vessel. He regarded periton- sillitis a very good name for quinsy, but he did not believe there was a peritonsular capsule proper. As to the tonsils performing their function, he did not think they existed in the normal state, but that they were the result of disease. The Academy then adjourned. ®0 VTCSP^O uclcucc. OUR LONDON LETTER. (From our Special Correspondent.) THE CHOLERA DR. LEWIS ON THE COMMA BACILLUS AND ITS NON-SPECIFICITV CANNIBALISM AMONG AN ENG- LISH SHIPWRECKED CREW HOSPITAL SATURDAY — THE HEALTH EXHIBITION AND THE HOSPITALS DEATH Of MR. NErrEN RADCLIFFE. London, September 20, 18S4. ^ Despite the prophets of evil, the dreaded cholera has not yet visited us. All possible precautions have been taken to prevent the introduction of a case into the kingdom. Steps have been taken to Aygestin Online prevent cargoes of rags from Buy Aygestin Online Marseilles and other ])laces from being landed at British ports in cases where there is any possibility of their bringing infection. With regard to the pathology of cholera, an interesting memorandum has just been issued on the subject by Dr. T. R. Lewis, Assistant Professor of Pathologj' at the Army Medical Norethindrone Acetate Tablets School, Netley. Dr. Lewis has lately visited Marseilles for the purpose of studying the subject practically. He criticises Koch's published reports rather closely, but the most startling point in his paper is the statement that comma-shaped bacilli have been found by him frequently in the salivary secretions from the mouths of healthy persons. This is evidently Aygestin Price a very important observation, and should it be confirmed by further in- vestigations, will go far to wholly discredit Koch's views on the bacillar origin of cholera. Dr. Lewis is a skilled microscopist and a laborious and patient worker in the field of pathology. Dr. Lewis has also studied cholera practically in Lidia, where he served many years as an army surgeon. His former studies on the filaria san- guinis hominis did much to elucidate the pathology of those organisms, and are probably known to many of your readers. While the story of the Greely Arctic expedition is still fresh in our memories, another horrible tale of cannibal- ism has just come to light. Three men and a boy going from England to Australia in charge of a yacht, were shipwrecked and drifted about in Buy Norethindrone Acetate an open boat for nearly four weeks. As a last resort they killed the boy, and after Buy Cheap Aygestin drinking his blood ate his flesh. His heart and liver were devoured while still warm. It is right to state that the boy was apparently dying. They continued to eat his flesh for several days, when they were picked up by a passing vessel. There is no doubt whatever as to the facts, as the men confess what they have done, and have been arraigned for murder. None of the injurious effects

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