in France. We can readily understand, therefore, the cause of the advantage derived from these waters in the treatment of patients affected with gravel, as well as those troubled with calculi of the bladder."

PRINCE LOUIS BUONAPARTE'S VALERIANATES.

If the Buonaparte family had never been employed in a worse manner than Prince Louis is now, it would have been better for mankind, though perhaps worse for them. Certainly they would never have been Princes, had they confined themselves to making preparations of quinine and zinc. The greatest of the name was chiefly given to steel.

Prince Louis, however, has communicated, in the Journal de Chimie Médicale, his methods of preparing the valerianates of quinine and zinc. Nothing is said of the medicinal properties of the salts. Those who are curious pharmaceutically, we must refer to the number of the Pharmaceutical Journal for Sep tember.

DR. HOULTON ON DIGITALIS.

Dr. Houlton read a paper on Digitalis Purpurea, before the Medico-Botanical Society, which has been reported in the Pharmaceutical Journal for September, and contains some valuable suggestions. These we shall extract.

"The parts of the plant to be employed in medicine named by authors, are the root, flowers, and seeds. Should any one wish to employ the root, the rule Dr. Houlton has given on various other occasions should be borne in mind, namely, the roots of biennial plants are to be collected in the autumn or winter of the first year of their duration; this rule he has never seen in any book, but it is an absolute one. Dr. Withering mentions, that Dr. Crowley, of Cambridge, was cured empirically of hydrothorax by the root, after regular practice had failed. The leaves of this plant, like the leaves of all biennials, should be gathered in the second year of their duration, and as soon as possible after the first flowers have expanded. The plant with a purplish stem should be selected; the leaves, after removing the midrib, should be carefully dried, without the aid of artificial heat; no rule is needed for the collecting of the flowers and seeds. In a work of distinguished rank it is asserted, that as digitalis is a biennial plant, its fresh leaves may be procured at any season of the year. Now this is not from its being a biennial merely, but from the circumstance of its being a very hardy biennial. The leaves of biennial plants die in the winter; in mild winters and in sheltered situations the leaves of digitalis will remain through the winter.

"Leaves have been offered for sale as digitalis, which were those of verbascum nigrum; they have much of the general appearance of digitalis leaves, and might deceive the unwary; other species of verbascum have leaves somewhat similar to those of digitalis.

"The usual preparations of the leaf are the powder, tincture, infusion, fluid, juice and extract. Dr. Houlton thinks no others are needed than the powder and the tincture, for the more simple we keep our vegetable Pharmaceutical preparations the better. It is worth noticing the changes that have taken place in the preparations of the tincture and infusion in the present Pharmacopoeia; they are both weaker than in the former Pharmacopoeias. The relative strength of the two tinctures is as 8 is to 10, and that of the infusion is as 8 is to 21here is a great difference; it is important to bear this in mind, when we compare the practice of authors who wrote previously to 1836 with those who have

written since. The infusion of the present Edinburgh Pharmacopoeia is double the strength of that of the London. The opinions of authors as to the dose of this medicine are curiously different. The ordinary dose of the tincture, according to those who are accounted the best authorities, is from ten to forty minims. Dr. Pereira states, he has frequently given a drachm of the tincture of the best quality three times a day for a fortnight, without observing any marked effect. He adds, I know that some practitioners employ it in much larger doses, as an ounce or half an ounce, with much less effect than might be imagined.' Dr. Pereira also states, that Mr. King, of Saxmundham, in Suffolk, gives from half an ounce to an ounce of the tincture in some cases with decided advantage; and that he, Mr. King, has given as much as two drachms to a child nine months old. Mr. King lives in Suffolk, a county in which we are informed the plant does not grow. He would like to know something of the history of Mr. King's tincture. Dr. Houlton would not advise any one to try such doses, prepared after the plan proposed in this paper, that is, from the genuine purple-stalked digitalis. He has seen very unpleasant effects from ordinary doses, when continued several days, and is inclined to believe that the discrepancies amongst authors in reference to the dose of this very important remedy, arise from the want of uniformity in the preparations they employ; hence they write on different things under the same names, and discordant statements are the necessary consequence."

DESTRUCTIVE CONSEQUENCES OF THE INDISCRIMINATE SALE OF POISONS.

In the last number of the Pharmaceutical Journal there are two letters on this subject, which deserve attention. One druggist writes that in the Times of that morning are four cases of poisoning by arsenic, three of them fatal. He protests: "that he never sells arsenic, nor substitutes any other preparation when arsenic may be asked for, as I consider this latter practice highly objectionable. Even when asked for 'fly-powder poison,' I have a great objection to supply this preparation, and frequently refuse it to the party who may ask for it, unless very well known to me. There are many other preparations which I think ought to be also denied, such as laudanum, prussic acid, sugar of lead, crow-fig, syrup of poppies, oxalic acid, and many others." This is, perhaps, going rather too far. Another Druggist, adverting to a case of poisoning by oil of bitter almonds, dwells on the careless manner in which chemists and druggists sell this article in small quantities, in a state of much greater concentration, for culinary purposes, than is safe.

He observes: "The use to which it is applied for flavouring spirit, has not only opened the door to its sale among large consumers, but any body may now a days obtain a little who has a mind to make his own ratafia or noyeau. The more objectionable form however to me is, the one from which the nearly fatal case alluded to above resulted, and that is the sale of the essence (as it is called) of almonds, where a few drops are directed as sufficient to flavour a pudding or custard. Now when we consider the hands into which these said essences generally come, and the careless way in which cooks are accustomed to guess at their proportions, and how little used they are to the word Guttatim'-I do think it would be much safer to supply the public with a more diluted articlein which spoonfuls might be used, and when the tempting flavour of the bottle, left carelessly about, would not involve anything like so much danger to those who like to have a taste of what smells so very nice."

He has known persons enter a shop for a pennyworth of morphia, colchicum being as much in demand as laudanum. This Druggist too, is in favour of the sale of poisonous substances being much more restricted than it is. All poison

ous articles, for whatever purpose bought, should have "poison" labelled on the bottle, &c. Unfortunately some cannot read, others will not, and still more do not pay attention. The druggist is, at least, bound to caution his customers on the nature of what they are purchasing. The safest plan, no doubt, would be to refuse to sell poisons, in whatever quantity, without a knowledge of the parties, and something like a guarantee of their purposes. In large quantities poisons should only be vended with the sanction of a medical certificate.

ON THE TREATMENT OF CERTAIN AFFECTIONS OF THE NECK OF THE UTEerus BY THE ACTUAL CAUTERY. By Dr. E. LABORÉE. (L'Expérience, Août 22.) This Essay consists principally of an exposition of the views and practice of M. Jobert. It appears that M. Jobert was encouraged first to practise this operation by the fact that the numerous nerves distributed to the uterus, on arriving at that part of the neck to which the vagina is attached, abandon the uterus, and are distributed to the walls of the vagina, so that the vaginal portion of the neck of the uterus is found to be destitute of nerves, as if the insertion of the vagina formed an impassable barrier.

1. Cases in which the Actual Cautery may be had recourse to.-With the exception of those slight ulcerations which accompany certain acute or chronic discharges, and which cease as soon as the principal affection is vanquished, and with the exception also of ulcerations of a syphilitic nature, almost all ulcerations affecting the neck of the uterus are susceptible of being attacked by the actual cautery. Thus, M. Camille Laurès enumerates amongst those cases which require cauterization, ulcerations which are exuberant or fungoid, or deep; which are complicated with bleeding, with simple hypertrophy, or with engorgement with softening or induration of the organ. Nay more, occasionally M. Jobert applies the caustic where no ulceration exists.

It not unfrequently happens that patients present an excess of volume of the neck of the uterus giving rise to numerous inconveniences, such as a state of habitual irritation of the vaginal mucous membrane-a painful pressure permanently exercised upon the rectum, for most frequently the uterus is in a state of antero-version-pain in walking-lassitude-lumbar pains, &c.

These symptoms, which frequently resist ordinary treatment, are, according to the author, promptly relieved by the application of the cautery to the neck of the uterus, and this is explained by the fact, that all the inconveniences experienced by the patient, are attributable to the excess of volume of the organ.

Another affection of the neck in which cauterization acts altogether as a specific, consists in the formation upon the surface of the organ, most frequently inside the lips, of a veritable erectile tissue, bleeding with the greatest facility on the least touch or the slightest irritation. In cases of this kind the patients soon acquire a chlorotic tint, which by degrees gives to the physiognomy that peculiar aspect so generally indicative of cancerous affections; a few cauterizations destroy the new tissue, and the constitution speedily recovers itself as soon as the exhausting cause is removed.

Finally, cancer, with or without uleration, when it is limited to the neck of the uterus, ought especially to be treated by the actual cautery, and we, (the author of the essay) should not hesitate to give in every case the preference to this mode of destruction.

On the Mode of employing the Cautery.-For this purpose you employ iron rods terminating in an expanded extremity, and a speculum of ivory to protect the surrounding parts, the ivory being a bad conductor of caloric. After having

wiped off with a piece of lint the muco-pus which covers the ulcerated surface, you apply the iron, taking care that it is at a white heat, in order that it may not adhere to the parts with which it comes in contact, or, in withdrawing it, you may pull the eschar which it has made.

On the Mode of Action of the Cautery.-The first effect is, and ought to be, the production of an eschar. Care ought to be taken that the iron be at a white heat, as otherwise the disorganization is not so complete, and more irritation is produced. The colour of the eschar is greyish; its extent may be, without fear, as considerable as that of the surface of the neck of the uterus.

Generally speaking, the patient does not experience, either immediately or consecutively, the slightest re-action. The whole power of the remedy becomes concentrated and exhausted on the place on which it is applied. The patient does not feel the cauterization at the time; she will not experience any ill consequence from it afterwards. Though the patients, however, experience no sensation of burning, they do occasionally suffer real pain-this pain resulting (according to the author) from the pressure made through the medium of the insensible or vaginal portion, upon the sensible or supra-vaginal portion of the neck of the uterus, which in these cases is diseased also.

Pain is experienced from the actual operation only in two cases; viz. 1st. If, by accident, a part of the vaginal parietes has been left uncovered, and which is then burnt by radiation; 2ndly, if it should be necessary to introduce the iron so deeply into the orifice of the neck as to arrive at the level of the supravaginal part. After the operation, the patients return to their beds as if they had only been undergoing a simple examination by the speculum. Out-patients even proceed at once to their homes. The re-action is so completely limited to the part touched, that menstruation is in no degree impeded by the operation. Several women cauterized on the evening preceding their usual monthly period, have seen the discharge appear as usual.

In eight or ten days time, the operation can be repeated, as most usually the slough has then separated. In its place is seen a lovely roseate suppurating surface, and the neck is diminished in volume. Sometimes the eschar is more slow in separating, but this is about the usual period.

After the required effect has been obstained from the operation in cases of hypertrophy of the neck, cicatrization is allowed to take place. There is nothing particular to say on the manner in which this takes place, it is completed generally in about twelve or fifteen days after the last cauterization, when the wound becomes covered with a delicate and transparent pellicule. When the operation has been performed for the purpose of destroying ulcerations, the application of the cautery ought not to be given up until the wound presents an even surface, without projections, and its aspect is reddish, uniform, and the liquid which it secretes is simply purulent.

MM. Laborie and Laurès both assert that this operation may be had recourse to without fear, as in no case has the slightest painful re-action followed the cauterization. Is it an infallible remedy? Undoubtedly not; but never, say they, can you find a more powerful remedy, and never will bistouri be able to destroy more effectively or more surely that which a healthy surgery ought not to allow to continue.

CHEILOPLASTIC OPERATION. BY THOMAS D. MUTTER, M.D.

(Medical Examiner, Philadelphia.)

The lower lip, from its conspicuousness, its utility in articulation, and also in the prevention of an involuntary and incessant flow of saliva, forms a very imNo. LXXXII.

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portant portion of the face. Unfortunately, it is exceedingly prone to diseases of various kinds, especially tumors and ulcers, requiring for their relief the removal of the whole, or a portion of the organ involved. It would be worse than useless to enter into a description of all the operations that have been devised to remedy its loss, but a brief sketch of the most novel and important may prove useful and interesting to those not familiar with this department of plastic surgery.

Chopart's Operation.-This operation consists in making, on each side of the diseased tissue, a perpendicular incision, which extended from the margin of the lip to a point below the base of the lower jaw. Dissecting up the flap inclosed between the incisions, he carefully removed from its upper margin all the affected tissue, either by a transverse or curvilinear cut. Then, pulling upon what remained of the flap, he brought its upper edge to the level of the margin of the natural lip, and there retained it by suture, straps, and placing the head of the patient in such a manner as to prevent all strain upon the part. This method, Dr. Mütter remarks, though apparently simple and easy of execution, does not generally answer, in consequence of the subsequent contraction of the tissue.

Horn or Roonhuysen's Operation.—If the part to be removed be small, the common V shaped incision is sufficient, and the parts may be brought toge ther as in the operation for hare-lip; but where the mass is large, this process is sure to diminish the orifice of the mouth, and thus give rise to deformity and inconvenience. To obviate all this difficulty, it was proposed by Horn to detach the adjacent parts by free dissection from the maxillary bones, which would of course afford more material for the lip. The objection to this method is, that in many cases the orifice of the mouth is rendered so small as to be almost useless, besides presenting great deformity.

Operation of Dupuytren. This, in ordinary cases, was nothing more than cutting away by a semi-elliptical incision all the diseased tissue. Granulations spring up from the margin of the healthy skin, occupy in part the place of the original lip, and conceal to a certain extent the deformity. It is only in mild cases, however, that such a measure could succeed.

Celsian Operation.-Having carefully removed the diseased part by a V shaped incision, proposed to divide the tissue remaining horizontally, carrying the cuts as far into the cheek on each side as be deemed necessary, after the manner of Horn: but, in order to take off the strain from the flaps, he made a semilunar incision in the cheek, just beyond the base of each. This enabled him to bring the parts together without difficulty; and the only objection to this operation is the danger of wounding the larger vessels, nerves, and ducts of the cheek, in making the semilunar incisions.

Operation of M. Serres.—If the disease, as is sometimes the case, is confined to the integuments and subjacent muscles, leaving the mucous lining of the lip sound, Serres cuts away only the affected part, and then turns the mucous membrane over the margin of what is subsequently to form the lip. A few stitches are sufficient to hold it in place, and as union by the first intention usually occurs, a very natural and useful organ may thus be made. This method, however, will only answer in cases of superficial and recent disease.

Operation of T. W. Roux.-After removing the affected tissues, and forming suitable flaps of the adjacent parts, M. Roux takes away with the saw or cutting instruments the prominent centre of the maxillary bones, so as to make room for the proper and easy adjustment of the integuments intended to replace the organ destroyed. This operation is barbarous, because unnecessarily severe.