not pass a small speculum without giving her great pain in the rectum. Oiling my finger and passing it up that organ, I found at three inches above the external sphincter, a tight, inflammatory stricture, through which only the tip end of the finger would pass, the edge of the stricture being sharp and well defined.

I wrapped a probe-pointed, curved bistoury to within half an inch of the point, and then, guided by the fore-finger of my left hand, passed it through the stricture, turned the knife up, and easily divided the sharp edge, so my finger would pass readily. I gave her a small tallow candle to pass occasionally, and she has since had no trouble.

In this case the patient had her mind so impressed with the idea of womb disease, that she came near misleading her physician. Transactions of the Minnesota State Medical Society, 1879.

Phymosis, Causing Retention of Urine. BY JAMES DAVENPORT, M. D., ST. PAUL. During the afternoon of March 26, 1879, a woman brought an eleven months male baby to me. She said that the child was cross and irritable, crying and straining, and that she thought the child had not passed any water for a "long while" -nearly two days.

The physiognomy of the child was one of distress and suffering. Questioning whether there was retention in a child of this age, I examined his abdomen, perceiving some little protrusion above the pubis, and percussion dullness about halfway to the umbilicus, with evident distress from pressure upon abdomen. There was also phymosis. The child had had a dose of castor oil which had not operated. I wrote a prescription containing spiritus ætheris nitrosi and liq. morphia sulph. U. S. P. Gave directions for an enema, a hot bath and hot, moist fomentations to the parts. About 11 o'clock that night, the father came for me, saying "the child was dying." I found the poor babe in most evident distress; short, catching respiration, eyes fixed and staring and a moaning

cry. Percussion dullness was higher than before. I immediately passed a No. 2 soft catheter, meeting with little resistance. Not more than two ounces of urine passed away, but great relief was afforded the child. The child had had the medicine ordered, but the other directions had not been carried

out.

The child continued to suffer for three days, various alleviative measures being tried, and, possibly, his diaper being wetted a little occasionally. The child was catheterized two or three times again, the eye of the catheter being one and one-eighth inch from the bulbous end, prevented my drawing but about two ounces at each operation.

I had believed from the first that the child's phymosis was the exciting cause of the retention, and, on the 29th, Dr. D. W. Hand assisting me, I performed the simple operation of circumcision. The mucus membrane was considerably adherent to the glans penis, with some little masses of smegma lying beneath. The wound healed nicely, the child regaining--after a slight catarrhal fever, a week after the operation, from exposure good form and health.

The question of peripheral nerve irritation, causing reflex trouble, was, as far as I know, first brought prominently forward by Dr. L. A. Sayre, of New York. His cases, published in the Philadelphia Medical and Surgical Reporter for October 14, 1876, showed at that time, as have many others since, that in phymosis an exciting cause may exist for severe reflex nervous disease. Infantile paralysis most prominently. Also, stone in bladder, enuresis, and, as in this case, retention.

The benefits of circumcision, when necessitated, are evident aside from the question of peripheral irritation.-Transactions of the Minnesota State Medical Society, 1879.

Nitrate of Amyl in Ague.

I tried this article for arresting the paroxysm in one case of this disease, as recommended in the last issue of the American Medical Journal, and it gave the happiest result. The cold stage was just coming on; hands and feet cold, and

chilly sensations in the region of the spine. Patient said the remedy appeared to go to the ends of the toes in a few seconds, with the effect of producing a glow of warmth, and a complete relief of the symptoms of chill. There was a very slight fever followed, but it subsided within an hour, succeeded by a gentle perspiration. By the use of other remedies, the chill did not return. Dr. J. W. Thrailkill, in The American Medical Journal.

Electro-Therapeutics.

(Concluded from September Number, Page 300.)

The uses of electricity, as a remedy, are very numerous, both in the general treatment of disease, and in special cases of surgery; but as this series of articles deals with cases which can be treated by simple apparatus, it will be necessary only to mention the most important classes of disorders to which it may be applied, and these will fall naturally under two heads: first, those in which electricity acts primarily on the nervous and muscular systems; second, where its action is primarily and chiefly chemical. The first class includes cases where the system as a whole, or single nerves only, are in an abnormal state, which may be either one of increased activity or one of depression, that is, of exalted or of lessened sensibility of the nerve, and of inflammatory or of atonic condition of a muscle.

There has been carried on, for some time past, a controversy as to whether the physiological effects of electricity on the nervous system were due to current direction or to polar influence, and partisans of either view may still be found. According to some authorities, the effect is produced solely because the current determines chemical changes throughout the entire length of the nerve or muscle which it traverses and electrolysis takes place over the whole of this region, so that, accordingly, acid is generated at one end and alkali at the other, these affecting the nerve subsequently by simple chemical action. The advocates of polar action do not undertake to explain why the nerve is affected, but content themselves with asserting that each pole exerts a peculiar influence which extends till it is met and neutralized by the emanations from

the other.

Both parties, however, admit the substantial correctness of the results obtained by Eduard Pfluger. He first established the fact that the passage of a moderate galvanic current longitudinally through a nerve divided it into two distinct portions, which he called, respectively, anelectrotonic and cathelectrotonic, one of these conditions being found near the anode and the other the cathode.

I will venture to change Pfluger's names to accord with the fundamental terms mentioned in the first of these papers, they will become, therefore, positive-electrotonic and negativeelectrotonic, the first referring to the state of the nerve at, and to some distance from the positive pole, the other to the region about the negative pole. The important observations of the German physiologist were these: That in the state of positive-electrotonus the irritability of the nerve was diminished, while it was increased in negative electrotonus, and that there was a neutral line of normal irritability where these two regions met. He found, too, that the strength of the current had a marked influence on the character of the effect produced. His laws may be epitomized as follows:

(1) The mildest currents applied to the nerve cause contraction only on closing the circuit, that is, on making the battery connection.

(2) Currents of medium strength cause contraction both at closing and opening in both directions.

(3) Strong descending currents (that is, from the center toward the periphery of the nerve) cause contraction only at closing the circuit, while strong ascending currents cause it only at opening.

For mild continuous currents it has been proved that the region about the positive pole will be in a depressed condition. If a motor nerve is operated on by a descending current, the result will be that after a time, varying from five to ten minutes, the irritability, or, perhaps, it would be better to say the tonicity of the muscles, controlled by that nerve, will be diminished. As a rule, too, the supply of blood to the muscle will be lessened. The opposite result will be obtained if the current is reversed.

With very long continued galvanic currents the

irritability of the nerve will be lowered independently of direction, but less rapidly by ascending than by descending currents. If strong interrupted currents, which give violent shocks, be employed, the effect will be always stimulating, provided the shocks are not excessive and are only applied for one or two seconds. If they are continued for many minutes in the same direction, they will exert a sedative effect, which may be pushed to temporary or complete paralysis. With alternating currents the stimulating influence is more marked than the other. Indeed, there is no application of electricity more intensely and purely stimulating than that caused by suddenly reversing the direction of the current through the patient.

The bearing of the general principles on the use of the induction coil will be apparent. The interrupted primary which, necessarily from the mechanism of the coil, flows always in one direction, is the best substitute for the galvanic current; it can be made nearly continuous, and, therefore, mild, by causing the spring to vibrate as rapidly as possible, say three or four hundred times per second. The vibrations are made very rapid by advancing the contact screw so as to make the excussions of the spring as short, and, consequently, a› numerous as the apparatus will permit. The reason why this arrangement will give a mild current is, because the quantity of electricity "stored" or employed in magnetizing the iron is very small-because of the shortness of time during which the battery current flows; consequently, when demagnetization occurs, the amount sent to the patient is small but it is sent very often. On the other hand, a slow vibration of the spring, of say ten or twenty a second, will give a series of shocks rather than a current properly so called. Thus it will be seen that the control of the spring is a matter of vital importance to the operator, and it is greatly to be regretted that instrument-makers have paid so little attention to this essential feature. A good induction coil should be provided with an interrupter which can be quickly and certainly adjusted to any rate-between five and five hundred vibrations per second.