exhibition of from fifteen to thirty grains of potassium chlorate three times a day, together with tr. ferri chloridi; two children were carried to full term and born alive. DR. ROBERT L. DICKINSON, of Brooklyn, L. I., has formulated' concise rules for extracting extended arms in breech labors. His rules are as follows:

1. Twist the child's body so that the shoulder lying nearest the sacrum is carried toward the sacrum.

2. Draw the legs and trunk sharply towards the opposite side and somewhat forward until the scapula is felt. This drags the

elbow down to the brim.

3. Slip in two fingers (or the flat hand) well forward under the pubic arch and reach along the child's humerus to the elbow.

4. Push the hand across the face, and then sweep it down the chest and across it, and out of the vulva.

5. Rotate the body to bring the remaining shoulder back to the sacrum, and the liberated arm under the symphysis.

6. Slip the fingers of the other hand under the pubic arch and along the child's arm, and attempt to sweep the elbow past the face. (6 a.) At the same time the other hand on the suprapubic region must push the occiput in the opposite direction so that the head turns on the neck, and elbow and face go over together. It is to this last manoeuvre that the author wishes to draw attention, as all the other steps are well recognized methods. This manœuvre is of advantage because the arm "jams" the projecting face and the projecting promontory unless the external assistance is employed.

[From the illustration, it appears that the child's feet are given to an assistant who is to keep the body taut in the position given it by the accoucheur.-ED.] Snoring, so it is claimed by DR. H. T. WEBSTER, of Oakland Cal., can be cured by excision of the uvula. The observations of MR. SMART as to the value of physostigma in relieving obstinate hiccough have been confirmed by DR. H. M. SHALLENBERGER, of Rochester, Pa. The remedy is given in the form of a fluid extract, in doses of from four to eight drops every two or three hours and may need 1. N. Y. Journal Gynecol. and Obstet., February, 1892.

to be pushed to the verge of toxic symptoms. A case of hysterical hiccough of three months duration, and which had resisted all other medication, yielded to this remedy in a few hours, though in some cases the drug must be used for upwards of forty-eight hours before its full beneficial effect can be realized. DR. WILLIAM TAYLOR,' does not believe in elastic stockings or operative treatment for varicose veins. He advocates blistering. The patient is put to bed and the limb elevated for twenty-four hours. The limb is then blistered from the foot upwards, six inches daily, close watch being kept meanwhile of the condition of the kidneys and bladder. As the blisters rise the serum is withdrawn. When the whole limb has been blistered, apply plaster to the entire length of the vein for two weeks. Remove the plaster, and if the veins bulge, blister again; if they are all right apply more plaster and allow gentle exercise for a week. If at the end of this time the veins are in good condition, no farther treatment is needed. Among the remedies to be borne in mind in treating peritonitis is pilocarpine. DR. MADISON REECE, of Abington, Ill., has employed it with morphine to allay the acute pain, in twenty-four cases, of which four were fatal. He gives a tenth of a grain by the mouth every three hours till free perspiration ensues. The best results seem to have been in cases of peritonites resulting from chill. DR. R. W. CORTIS, of North Sidney Australia3, reports an interesting case of atropia poisoning in a child of 18 months treated by hypodermatic injections of pilocarpine. Result, recovery. The child, so its mother stated, had drank from a two-ounce vial containing in solution four grains of atropine sulph, and six grains of cocaine. About an hour before the physican saw it, the patient was unconscious, its pupils widely dilated, its pulse slow and feeble, and no effort could arouse it. Though the stomach was thoroughly washed out with the stomach pump the patient passed into deeper collapse. One-seventh of a grain of pilocarpine was injected under the skin and in fifteen minutes the pulse had improved and the

1. Medical Press. 2. Medical Standard, March 1892.

3. Australas. Medical Gazette Feb. '92.

dilatation of the pupils had lessened somewhat. In about an hour the dose of pilocarpine was repeated and a little whisky and water was given. The child then began to improve and in a couple of hours had so far recovered consciousness as to try to take a little milk, though it did not appear to see distinctly. Within twentyfour hours, it appeared to have recovered, though very weak. It would thus appear that pilocarpine is a complete antidote to atropine. L. B. T.

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THE INTERNATIONAL MEDICAL ANNUAL, AND PRACTITIONERS' INDEX, A Work of Reference for Medical Practitioners. Published by E. B. Treat, 5 Cooper Union, New York. Price, $2.75.

This is the tenth year of this valuable publication. The publishers, in the preface to this volume, say that "It is not extraordinary that a work which undertakes to afford information on every subject connected with the professional requirements of medical practitioners should find the demands upon its space grow greater year by year. We have never hesitated to enlarge the size of the volumes in order to meet these demands, and the rapidity with which the circulation of the "Annual" has increased has not only

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DISEASES OF THE EYE. A HAND-BOOK OF OPHTHALMIC PRACTICE. By G. E. DeSchweinitz, M. D., Professor of Diseases of the Eye, Philadelphia Polyclinic; Ophthalmic Surgeon to Children's Hospital and to the Philadelphia Hospital; Ophthalmologist to the Orthopedic Hospital and Infirmary for nervous diseases; Lecturer on Medical Ophthamoscopy. University of Pennsylvania, etc. Forming a handsome royal 8vo. volume of more than 600 pages. Over 200 fine wood-cuts, many of which are original, and 2 chromo-lithographic plates. Price, Cloth, $4.00 net; Sheep, $5.00 net. W. B. Saunders, Philadelphia, 1892.

The general plan of the book is practical, and the methods of examining eyes and the symptoms, diagnosis and the treatment of ocular diseases and refractive defects are everywhere brought into prominence. Attention is called to the following points:

I. The systematic directions for recording each case of ocular disease and for making the examinations necessary to lead to an accurate diagnosis, beginning with direct inspection of the eye and passing in review one method of precision after the other until all the functions of the organ have been investigated.

II. The careful explanation of the two methods of ophthalmoscopy, and the cautions which help the student to use the ophthalmoscope properly and prevent him from falsely interpreting its findings.

III. The judicious classifications of the various diseases of the eye facilitating their study, together with useful tables for differential diagnosis.

IV. The symptom-grouping, which, with each important general disease, precedes the special symptoms of the various types, e. g., in glaucoma, cataract, iritis, choroiditis, retinitis, optic neuritis, etc.

V. The careful pointing out of the indications for treatment, and the detailed method of treatment, both medical and surgical. VI. The explicit directions for preparing a patient, the hands.

of the surgeon, the dressings, and the instruments preparatory to an operation, and the detailed description of the s.eps of the important operations.

VII. The selections of the illustrations (nearly one-third of which are new), which materially facilitate the understanding of the directions.

VIII. Special attention is called to the work of Dr. James Wallace, who contributes ::

(a) The chapter on GENERAL OPTICAL PRINCIPLES, including ACCOMMODATION and Convergence. The descriptions are clear, and especially valuable to students are the practical directions for combining spherical and cylindrical lenses.

(b) The chapter on NORMAL and ABNORMAL REFRACTION, in which all that is theoretical is well explained, and-what is most useful--the pages are replete with practical directions for determining the refractive error, illustrated by numerous examples. The sections on ASTIGMATISM and PRESBYOPIA are especially clear in these respects. The addition of a Section on SPECTACLES AND THEIR ADJUSTMENT is most valuable. These directions are seldom found in text-books and are nowhere so explicitly recorded. (c) The section on REFLECTION, which suitably precedes a clear account of the Ophthalmoscope and its Theory.

(d) The portions devoted to the ROTATION OF THE EYE-BALL Around the Visual Line, and the explanation of the Projection and position of the images in trabimus, illustrated with Dr. Wallace's original drawings, which greatly help in the understanding of these difficult subjects.

(e) The carefully classified CAUSES OF CONCOMITANT SQUINT and the terse explanations.

IX. The Contribution of Dr. Edward Jackson on RETINOSCOPY, which is an elegant and practical description of this method of determining refractive error, written by the master of the subject, and illustrated by examples and original drawings.