Texas laws, I am informed, are about the same; in fact, the laws of the United States, England, France and Germany are all about the same, especially in France and Germany, where the law is very strict. According to an eminent teacher of medical jurisprudence, J. L. Casper, who says that "Of all the many accused, never a one was condemned, and in no one case was the crime proven." The States of Maine, Massachusetts and New Jersey have ruled by their supreme courts, that "to cause or to attempt abortion before quickening is not to be indictable even as an assault, if done with the consent of the woman." The Pennsylvania court, however, has discarded this doctrine, and has decided that the very moment the womb is instinct with embryo life and gestation has begun the crime may be perpetrated. "The distinction alluded to with regard to quickening is allowed by an acknowledged legal authority, Wharton, Criminal Law of the United States, 537, to be at variance, not only with medical experience, but with all other principles of common law. The civil rights of an infant in utero are respected equally throughout gestation, at every stage of which process, no matter how early it may be appointed executor, is capable of taking as legatee or under a marriage settlement may take specifically as a child under a general devise and may obtain an injunction to stay waste." "When in an attempt to procure abortion there is an evident intent to produce the death of the mother, and her death does actually occur, such attempt becomes murder at the common law." "But when it is only intended to commit the misdemeanor, it becomes manslaughter." The above citations of law are sufficient to show how the law defines and punishes the criminal abortionist for his offense against the laws of the country, not to say anything about his or her offense against God and society at large. To my mind this is one of the most heinous crimes known among races, and establishes the fact, beyond contradiction, the degeneracy existing in the human heart, not to mention its moral and legal effects on society. Oftentimes abortion is in its very nature a secret crime The abortionist and his patient act in concert. The patient applies to the abortionist and submits herself to his treatment. Or the midwife and the pregnant woman arrange the former to procure and the latter to take certain drugs. Besides the persons concerned, no human ear heard what was agreed to, no human tongue can testify positively what was done.

Thus the patient becomes the accomplice of the abortionist. You all know how the law views the evidence of accomplices. The secrecy and the enormity of criminal abortion makes it the more

urgent upon the medical profession, especially of this great commonwealth, to exercise all of their influence against abortion by artificial means or any other noxious thing, unless the life of the mother is in imminent peril, and then only to resort to it after matur consultation.

For Texas Medical Journal.

Apomorphia.—Its Origin and Therapeutics, as Applied in Asphyxia, Drowning, Lightning Stroke, Emetic in Ejecting Poisons from the Stomach, Labor, Fever, Strangulated Hernia.

BY THOMAS J. PUGH, M. D., BRYAN, TEXAS.

It is the chemist who is generally the pioneer in bringing to the notice of the physician the probable and possible therapeutics of a remedy; but it is often left to the doctor in actual practice, and not unfrequently it falls to the lot of the obscure doctor, hid away in some out-of-the-way section, to bring forth the new or the old remedy to a fuller realization of its value.

In searching our literature on the subject of apomorphia we find in our U. S. D. (16th edition, page 215, and 17th edition, page 186) that apomorphia was discovered by Dr. Mathieson and Mr. Wright.

This preparation is made by heating morphine in a closed tube, with a great excess of hydrochloric acid, for two or three hours, at a temperature of 140° to 150°.

The contents are then treated with bicarbonate soda and the precipitate exhausted with ether or chloroform.

Apomorphia may also be made by the action of hydrochloric acid on codiene, and it is affirmed that the best method in practice is that of E. Meyer, in which morphine is treated with a solution of zine chloride at 120°.

Just here I would suggest that oftentimes the doctor wants a quick and unfailing emetic, and to this end, it might be well to have our chemist to add to his apomorphia, emetine, which you all know, in suitable doses, to be a reliable emetic.

With this prelude, I propose to go at once into the therapeutics of apomorphia.

*Read before the Brazos Valley Medical Association, at its eleventh semiannual meeting, at Calvert, Texas, May 15, 1901.

Its sphere of usefulness is indeed far reaching, and I am persuaded that if used opportunely, many valuable lives might be saved which otherwise "perish from lack of knowledge" of the value of this simple remedial agent.

In asphyxia, from any cause, where life seems to be extinct, and where we must have respiration to put the wheels of life in motion, apomorphia, in one-tenth grains every ten minutes, given hypodermically, in the arm or over the stomach, is the sheet anchor of the physician. In such emergencies, of course if death is so profound that reflex action is destroyed, neither apomorphia nor any other remedial agent will avail anything.

In 1893, it was my pleasure to meet with the N. A. Railway Surgeons at Omaha. During my stay there, one morning at 8 o'clock, Drs. Tally, Dewey and myself were summoned to an upper story of the Barker Hotel, to see a man who had come in the night before from the west, and on retiring to his room at eleven o'clock had failed to turn out his gas, but had blown it out and gone to sleep. Next morning the doctors, myself among the number, found him profoundly asphyxiated from the escaping gas. The two physicians with me, after examining the man, said he was dead beyond all hope, and as we started to retire from the room, I asked one of the doctors if he had a hypodermic syringe and a vial of apomorphia, to which he responded in the affirmative. The syringe was handed to me, and I at once gave the patient one-tenth grain of apomorphia, hypodermically. Within two minutes, the man was vomiting freely, the diaphragm was acting, respiration was re-established, the heart's action was restored, and the man who a few moments before was more dead than alive was on the road to a safe recovery, in thirty minutes being out of danger, and two hours after he left the hotel, completely restored.

In drowning, I would commend this drug, hypodermically, as it restores suspended respiration, and does away with the necessity of artificial respiration.

I believe this would be the appropriate remedy in lightning stroke. I also think blood-letting should be resorted to in addition to the use of this remedy. I am persuaded that in the lightning stroke we have a more complete stasis of the blood current, and therefore I recommend blood letting as an aid in reestablishing the circulation of the blood, and it must be evident to all that blood letting will, to a certain extent, relieve the overgorged organs and tissues, thereby aiding pulsations and respiration.

In morphine of opium poisoning, in any of its forms, apo

morphia, hypodermically, is the remedy. I visited a woman in my town who, with suicidal attempt, had, some ten minutes before I saw her, swallowed twenty grains of morphine. She was as black as a black hat; she was deeply narcotized. I had to resort to my remedy, apomorphia, and in five minutes vomiting set in, her respiration and circulation grew better, and the woman was saved.

It is the remedy, at least one of the valuable remedies, in retarded labor, due to rigid os. The obstetrician will value it when he has used it. It is useful in stubborn fevers, sometimes aborting them as by magic.

Now, last but not least, we come to its use in strangulated hernia. We have a case before us; we have used every effort in finger manipulation; we have even given chloroform and tried to reduce the constricted gut. We have failed. What next? The knife? No; let us give the patient one-tenth grain apomorphia hypodermically. We get vomiting in five or ten minutes; if not, repeat the dose. The patient vomits freely. Place him head downward, raise his hips, and if he is not inclined to sleep give him onefourth of a grain of morphine, hypodermically. The patient goes to sleep and rests perhaps for an hour; when he awakes, the gut is in its proper place. Relaxation due to the vomiting, sleep induced by the morphine, together with gravitation, does the work.

I have treated quite a number of strangulated cases in this way, and always successfully. I have never yet failed in the accomplishment of the ends desired with this drug, in strangulated hernia.

For Texas Medical Journal.

Four Cases of Appendicitis, Illustrating Four Types of the Disease.*

BY A. L. HATHCOCK, M. D., PALESTINE, TEXAS.

So much has been said and written of appendicitis that it is scarcely possible to say anything new upon the subject, but its frequent occurrence, the great uncertainty of its course, its rather frequent innocent appearance, and its only too frequent disastrous result, makes it a subject full of interest to every physician and surgeon, as well as to the layman.

In this paper, which I will make as brief as possible, I wish to present, in the order of their gravity, several cases of appendicitis

*Read at meeting of East Texas Medico-Chirurgical Society; May 31, 1901.

which have occurred in my practice, and which I have selected because they each represent one of the recognized types of the disease and furnish a picture of its phases from the mild to the malignant form.

CASE I. CHRONIC RECURRING APPENDICITIS.

A. H., age 19, male. I saw this case first in August, 1896, at which time he gave a history of attacks of severe colicky pains, attended with vomiting, fever, constipation, and tenderness located in the right illiac fossa. The last of the attacks lasted three weeks and was very severe, the temperature running about 104° F. for two weeks. There was more or less griping and pain in abdomen at all times, and he had constantly to use laxatives in order to secure an action. I advised an operation, but it was deferred, and I did not see him again until October, 1898. In the mean time he had another very severe attack, and several milder ones. The condition was similar to that already stated. No tumor could be felt, but there was great tenderness in the right side.

On October 22, 1898, the appendix was removed, and he had a good recovery, retarded by suppuration of the abdominal wound. due probably to infected catgut.

The appendix was two and one-half inches long, about the size of a lead pencil, with thick, hard walls and a very small cavity. The extreme tip was slightly dilated, and contained a very small amount of mucus. There was no pus.

CASE II. CHRONIC SUPPURATIVE ENDO-APPENDICITIS.

W. G., male, age 22. Consulted me in June, 1901, with this history: About two years ago he was attacked with pain in abdomen and some nausea, lasting about half an hour. During the following eighteen months he had several light attacks, none of them severe enough to put him to bed, and a diagnosis was not made. About six months ago he had the first severe attack, which came on while he was chopping wood. This was attended by severe pain, nausea and vomiting, followed by fever and localization of the pain and tenderness in the right illiac fossa. The muscles were hard on the right side of the abdomen, and the side was also distended somewhat with gas. No tumor could be felt, although an obscure thickening could be made out.

After several attacks like the above, he finally consented to an operation, and the appendix was removed on March 2nd, through an opening made by cutting through the skin and fascia and sep