recommended means in a case of dysentery, I had resorted to the treatment practiced a hundred years ago, and in the Annals of Anatomy and Surgery, December, 1883, I published the gratifying results of my method in this case. During the last twenty-five years I have inflated the rectum with carbonic acid in all cases of dysentery which have come under my treatment, and invariably have noticed the prompt effect on the tenesmus and the curative influence on the disease. As a rule, patients have spoken with enthusiasm of the relief they obtain. The physiological effect of carbonic acid gas inflation suggests itself as a most rational remedy in cases of dysentery, and I can not conceive any reason why this method of treatment, which is simplicity itself, has not become popular, except it is just this simplicity which is not appreciated by physicians, who prefer complications. If we were living in the seventeenth century, at the time when calisaya bark was introduced into Europe, there would be another reason for its not becoming popular. Physicians in the year 1640 were against the use of calisaya bark because it cured intermittent fever too quickly, depriving them of a certain amount of income.

The carbonic acid generator to be employed for inflation can be improvised at any drug store, and is inexpensive.

A. ROSE, N. Y.

Puerperal Convulsions.

Editor MEDICAL Brief:

PERRY, S. C., August 5, 1908.

In August number of BRIEF, page 439, is an article by Dr. John Snow, of Pine Apple, Ala., entitled, "Puerperal Convulsions," in which he makes some timely remarks, and gives a good treatment.

Having had a large and long experience in puerperal convulsions, I will give through BRIEF my treatment for same. As I understand it, puerperal convulsions are only symptoms of a deeper underlying cause, namely, uric acid poisoning. In nearly all, if not every one, you can tell by prominent symptoms several weeks beforehand when you may expect such an outcome. When confinement takes place the patient will invariably complain of headache, shortness of breath, swelling of the feet and hands, sometimes all over; they will become pale and anemic; the headache becomes most troublesome; also a very scanty supply of urine is voided at this time. If these symptoms are found in a patient near the end of pregnancy you may be certain to expect to encounter convulsions during or after confinement.

Now, if you can see your patient several days before confinement takes place, you can, with the use of cream of tartar and veratrum viride, cut short or entirely avoid convulsion. I have given veratrum viride (Norwood's) in twenty- to thirty-drop doses, hypodermically, with the most

gratifying results. Sometimes a much smaller dose will suffice, as I consider veratrum a specific and antidote in all cases of uremic poison, given in proper dose, which must be ascertained by strength of patient, for it will certainly bring about a reaction that is permanent and beneficial. The above dose may seem to you, at first, as being very heroic and out of all reason, but I have administered it in from five to thirty minims in thirtyodd cases in the last ten years without having had to regret it in a single case. I generally try to make my dose to suit the urgency of the symptoms present, or the amount of uric acid that seems to present itself at the time I am called. In the thirty cases I used the drug hypodermically in every case. When reaction takes place between the veratrum and the uric acid poison, there is generally some very alarming symptoms, and you may think your patient is paying you her last tribute of respect, but in a few minutes your heart will be made to feel glad by seeing the return of life again, without the convulsions. I have never seen a patient have a single convulsion after you have once stopped them with veratrum viride. The antidote to veratrum viride is sulphate morphine, also to be given hypodermically, and I have not yet had to give the antidote in any larger dose than one-quarter grain. I could report several interesting cases of puerperal convulsions, but time will not admit, and I am also taking up too much of your valuable space. I will report them later.

J. A. MILHOUS.

CASE OF IDIOSYNCRASY FOR EGG-ALBUMIN.

P. Landmann (Muench. Med. Wochenschrift, No. 20, 1908, Archives of Diagnosis, July, 1908,) report this case of idiosyncrasy which existed throughout the patient's life, beginning in earliest childhood. Proteids other than the white of egg did not nauseate the patient. As a boy he was affected with urticaria, brought about by ingesting egg-albumin which he had partaken unknowingly. If he takes egg-albumin in the smallest amount (without his knowledge) toxic phenomena of an alarming character will invariably supervene, such as vomiting, diarrhea, etc. If the egg-albumin is applied externally, the untoward reaction will also occur. Auto-suggestion is absolutely excluded.

MERCURIAL INTOXICATION.

Bernard and Troisier (Gaz. des Hopitaux, No. 61, 1908, Archives of Diagnosis, July, 1908,) report a case of mercurial poisoning in which cerebro-spinal symptoms were present. The cerebro-spinal fluid showed lymphocytosis and albumin. The patient was intensely anemic. There was a temporary icterus which the writers thought was hemolytic, and due to the anemia.

CURRENT MEDICAL LITERATURE.

The Function of the Greater Omentum.

B. Prsewalski (Berliner klin. Wochenschrift, July 6, 1908) takes up the question of the function of the greater omentum. Descriptive anatomy calls attention to the omentum majus, the omentum minus, bursa omenti majoris et minoris, ligamentum gastrocolicum, gastrolienale and phrenicocolicum. It has been definitely established that the suspensory parts of the omentum system act mechanically by holding up the intestines and by protecting the abdominal glands from injury. But little has been said, however, concerning the function of the free greater omentum. Ranvier thought that the greater omentum is identical functionally with the lymphatic glands, but this has not been subscribed to by all observers. Roger thinks, for example, that the omentum is a special bacteria-destroying protecting organ, while Boeri and Renci give it as their opinion that the omentum has a special anti-toxic action, basing this conclusion of their animal experiments as follows: Normal animals continue to live after ligation of the splenic blood vessels, but die after resection of the omentum. Witzel thinks that the omentum is a blood regulating apparatus for the abdominal organs. Heger maintains that the omentum acts as an absorbing medium, because it takes up particles of metallic powder, etc. (established by X-ray pictures). Morrision took up the radiography of the omental function, calling it the "abdominal policeman," acting quickly against anything inimical to the contents of the belly. Milian called its function the "defensive epiploic mobilization" and endeavored to ascribe to it a kind of intelligence.

There are certain complicated epiploic functions which are elementary to the greater omentum, and they can be classed as follows:

1. Watery and crystal solutions are absorbed by it (G. Wegener, Danielson, the latter considering this property due to the blood vessels).

2. It takes up colloidal substances, bacteria and uninuclear bodies such as India ink, cinnabar, etc. (Muscatello, Heusner, Danielson, which property the latter ascribed to the lymph vessels).

3. It presses firmly upon the intestines during peristalsis and remains. pressed firmly against the gut.

4. It overcomes certain kinds of peritoneal inflammation.

5. It encapsulates certain kinds of abscess formations, assisting in wound healing (Jobert, Carnot and Corneil, Tietze, Enderlen, Senn, Girgolaw, Rindfleisch, Rydgier, Braun, Bennet).

While these elementary functions are well understood, yet the principal function of the greater omentum has not been made clear, i. e., its presence prevents intestinal occlusion by keeping the bowels from twisting themselves during peristalsis. A number of experiments on dogs, made by the writer, showed this to be its function. In other words, it regulates peristalsis and therefore deserves to be called "ligamentum convolutorium intestini tenuis."

Ventrosuspension an Unsafe Operation for Posterior Displacement of the Uterus During the Child-Bearing Age.

E. B. Cragin (Surgery, Gynecology and Obstetrics, July, 1908) calls attention to the fact that since the publication of the paper of Noble, in 1896, on ventrosuspension, it is recognized that a firm fixation of the uterine fundus to the anterior abdominal wall is followed in a certain number of patients, who subsequently become pregnant, by a dystocia perhaps so marked as absolutely to indicate Cæsarian section. Two varieties of fixation of the uterus have been performed; first a ventrofixation, where suture is passed through the entire abdominal wall except the skin, and then through the fundus uteri; secondly, ventrosuspension, where suture is passed through the peritoneum and subperitoneal tissue of the abdominal wall and then through the fundus uteri, the object of the operation being to get a suspensory band or bands allowing mobility of the uterus, but no retroversion. We know that many operations for ventrofixation have resulted in practically ventrosuspensions, i. e., the adhesion between fundus and wall stretched sufficiently to allow mobility of the uterus; also it is true that ventrosuspension may become ventrofixed in any one of the following ways: The area of adhesion between uterine fundus and abdominal wall may be broader than expected and the resulting band may be too firm to allow uterine mobility. Secondly, infection of the abdominal wound may fix the fundus and the anterior uterine wall firmly to the abdominal wall. Thirdly, a ventrosuspension which allows a normal delivery in the first pregnancy following operation may subsequently become a ventrofixation, and produce dystocia so marked as positively to indicate Cæsarian section in the second postoperative pregnancy.

Cragin further points to the anatomical results of pregnancy in a uterus firmly fixed to the anterior abdominal wall as follows: The only part of the uterine body that expands to accommodate the growing foetus is that behind the point of suture attachment to the abdominal wall; the point of suture attachment of the uterine walls shows a thickening and sometimes actually a muscular tumor above and below, forming a marked obstruction in the parturient canal; that part of the uterine wall behind the point

of suture attachment may become so thinned during pregnancy as to rupture during labor (vide experiences of Von Guerard, Dickinson, Brodhead, Clark and Bowley, Edebohls and Ingalls); the cervix is thrown upward and backward so that at full term it may be at the level of or above the promontory of the sacrum.

Cragin catalogues five cases where ventrofixation later required the performance of a Cæsarian section in each and every case to permit delivery of the child from the pregnant uterus. These five cases represent operations performed by five different men, and save in the fifth case it was not known whether ventrofixation or ventrosuspension was intended. The fifth case was a ventrosuspension, performed in 1902, for the correction of retroversion. In 1903, she gave birth to a child without any difficulty, yet when she was pregnant again, in 1908, it was impossible to deliver the child at term, save by means of a Cæsarian section, owing to the fact that in the six years elapsing since the time of the ventro-suspension operation, the adhesion-band had become so thickened as to practically act as a rigid and immovable bar, effectually holding up the cervix and preventing delivery in the natural way. This case seemed to demonstrate beyond a doubt that ventrosuspension is an unsafe operation for posterior displacement of the uterus during the child-bearing age.

The Thermal Death Points of Pathogenic Micro-Organisms in Milk.

M. J. Rosenau (Hygienic Laboratory, Bulletin No. 42, U. S. P. H. and M. H. S., 1908) states that the temperature at which milk should be pasteurized hinges upon the thermal death points of the pathogenic bacteria which contaminate it. The pathogenic bacteria, commonly found in milk, are those causing tuberculosis, typhoid fever, diphtheria, scarlet fever, dysentery and Malta fever. The staphylococci, streptococci, and the organisms causing infantile diarrhea, are all readily destroyed by heat. Rosenau gives a review of the literature covering the question, and then gives the details of a number of carefully-conducted experiments performed by him to determine the question in hand. As a result of all his experiments, he concludes that it is difficult to determine precisely at what moment, or at what temperature a micro-organism dies. The fact that a micro-organism will not grow upon artificial media is not always a sure sign that it is dead; but, with the exception of the tubercle bacillus, it is safe to assume that, ordinarily, bacteria that fail to vegetate upon suitable media, under favorable conditions, have at least lost their virulence and power to infect, especially when ingested by the mouth.

The vegetability of micro-organisms in vitro does not always correspond to their ability to grow in the animal host. This is especially true of the tubercle bacillus. On account of the reluctance with which this