Exception Second-The ovum may die and be long afterward retained within the uterus. Velpeau "says when the child has ceased to live it is generally thrown out by the uterus, but in some cases its expulsion does not take place for a considerable period." He saw a case in which the child died at seven months-was retained twentyeight days afterward, and another in which the signs of gestation disappeared at six months, the "belly lost half its size," and when he wrote, eight months afterward, there had been and were still no signs of miscarriage. Churchill says "it is a matter of common experience that women retain a dead foetus in utero for weeks or months."† M. Prout had in his collection a foetus of three or four months, which was not discharged until five months after the symptoms of abortion. Cazeaux says "the term for the discharge of a dead foetus is not uniform-it is not uncommonly retained for weeks or months "-he has known many women to carry a dead child several months.‡ Velpeau says that under the conditions which existed in my case (that is when the membranes remained entire), the ovum may be carried not only for seven months, but even for several years.

It is to be understood however, that these are exceptions to the operation of a general law of delivery. The conservative forces of the animal frame are usually on the alert to expel every intruder upon the corporeal good, and at once to eliminate and reject all dead matter, whether in molecules or masses, which can threaten it with danger. The uterus is no laggard in her watchful care in these respects, and if the dead ovum is not expelled soon after its vitality ceases, it rarely passes the full term which nature, in the outset, designed it to remain within the body, without an effort, either successful or unsuccessful, for its discharge. This is a law not only of intra, but also of extra uterine gestation. The testimony of observers is, that in pregnancies of the latter kind, at the close of the usual term of utero-gestation, if not before, the womb makes expulsive efforts, as though it contained the foetus. Schmidt reports a case where the gestation lasted three years, and within the period labor pains were renewed eight times; and Cazeaux one of ten years, in which the pains recurred regularly at periods corresponding with the term of utero-gestation.

Exception Third-The ovum may be long retained within the body of the mother without undergoing putrefactive decomposition. a. It may be mummified, and as completely preserved, as though

it had been steeped in alcohol, as in my case reported. Velpeau states that if the membranes are not broken, and the air does not get access to the interior, the foetus may be preserved without change for several months, or even several years, which has given rise, I presume, to supposed pregnancies of fifteen, twenty, or thirty months duration, &c., that are spoken of in the scientific collections. This occurrence is met with particularly in compound pregnancies-one of the foetuses dies at two or three months-the other continues to grow, and at the lying-in the practitioner is astonished to receive both a full grown child and an abortion.* M. Martin, of Lyons, says "the mode of alteration varies with the period of pregnancy at which the child dies. * ** * From the second to the fifth month it withers away, becomes shriveled and dried up, and looks like a little mummy of a yellow color, or like a foetus preserved for a long time in alcohol." "Not unfrequently the placenta likewise participates in this state of desiccation." Simpson says "when the dead foetus is thus retained, it is preserved free from the decomposition usually following death, by all access of air to it being prevented. Sometimes it retains its usual rounded appearance and form, if it continues to be surrounded by a sufficient quantity of liquor amnii."‡

By consulting Dr. Montgomery's Obstetrical Essays, numerous cases bearing upon these facts will be found reported.

In extra-uterine pregnancy where the foetal mass is of necessity retained within the body of the mother beyond the term of its life, the same facts are observed. The products of conception are often encysted in a dense fibrinous sac, in which they are perfectly preserved for many years. Dr. Ramsbotham mentions a case in which he twice attended a lady in natural labor, and through her abdominal wall he could feel the limbs of a foetus which was the result of a previous extra-uterine pregnancy. In other cases of such gestation the ovum is incased in a hard calcareous crust in which it is preserved and carried for a quarter or half a century. Dr. Montgomery, in the essays quoted, relates a case of a foetus in utero, which was preserved, encased in a red calcareous deposit, aud Dr. Gooch two similar circumstances, which occurred at different pregnancies of the same woman.

b. Such dead and retained foetuses are at other times transformed into an osseous or cretaceous mass, resembling petrifactions. Almost all writers upon extra-uterine foetation give examples of this, and authority is not wanting to prove its occurrence in the uterus.

C. Such foetuses are sometimes converted into adipocire, and in this state retained with the body an indefinite period of time. This substance is a species of soap into which the fatty parts of the body may be converted by maceration in water under circumstances which favor it. The experiments of Chevreul have proved it to be an animal soap with a base of ammonia or lime; the ammonia being the result of the decomposition of the nitrogeneous principles of the body, while the fat becomes acidified. This change more commonly occurs in extra-uterine foetation, but if I read * Velpeau aright, I have his authority for saying that it may and does occur in the uterus.

Query Second-Is the conclusion that a dead foetus was carried twelve months in utero compatible with the fact that the patient's health was undisturbed during this time?

Cazeaux says, "as a general rule the prolonged retention of a dead infant does not produce any disastrous result to the mother, and I suspect that writers have greatly exagerated this point: they say indeed that the woman becomes depressed, uneasy, and of a fretful temper: that she experiences lassitude, alternations of heat and cold, oppression at the epigastrium, headache, syncope, palpitations of the heart: her face is pale, the eyes dull and surrounded by a lived circle, the breath fetid, pulse frequent and irregular: in a word, all these general phenomena of a slow fever have been considered by them as so many rational signs of the child's death. But these symptoms are certainly absent in a majority of cases. I have known many women to carry a dead child for several months without ever suspecting it."†

Other and confirmatory authorities might be cited upon this point, but as my paper is growing too long, I will submit it to your criticism without further comment.

USE OF COLLODION IN ENTROPIUM.

BY S. B. ROBBINS, M. D., OF LAWRENCEBURG, INDIANA.

Among the many and varied uses of collodion by the surgeon and physician, to which our attention is so frequently called by standard authorities, and in medical periodicals, I do not remember to have seen

Velpeau's Midwifery, page 242.

† Cazeaux Mid., p. 338.

any especial attention directed to the value of this agent in the treatment of perverted conditions of the eyelids; so I trust I will be excused for giving, briefly, my experience in the treatment of such cases, by collodion; but more particularly, cases of entropium.

For this condition of the lid I have used it with very great success, overcoming several very bad cases of long standing, and I imagine there are but few cases of entropium but will yield to the thorough and repeated application of collodion. Simply a good article of commercial collodion applied to the outer surface of the inverted lid, with a brush (or what I have found equally as good, the end of the cork with which the bottle is stopped), several times per day, as occasion requires, effects, by its mechanical power to contract the surface upon which it is applied, an immediate contraction of its outer surface, and consequent bringing of the ciliary margin to its natural position. If one application is insufficent to bring the cilia into position, we can repeat it until the desired position is attained, where it may be held for any length of time, by repeating the application. And this gained, you have gained all that is offered by any other mode of treatment with which I am conversant, be it either of the many operations proposed, or the application of compress and bandages, adhesive strips or sutures. It can be applied without any inconvenience; produces no pain, but a warm, pungent sensation; is very cleanly and not unsightly, and the tears that prevent the thorough use of adhesive strips, and excoriate the skin under the compresses, have no effect upon the surface covered with collodion; the lid loses its reddened, swollen look, and assumes a more healthy appearance. * *

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* * * * * In ptosis I have used it with equally good effect, especially in cases occurring in aged persons, and have been led to believe (by experience) that it exerts some influence in restoring to healthy action the levator palpebræ muscle when rendered inactive by palsy of the third

nerve.

I hope that these jottings may be worth your attention, and that they may be of benefit to physicians having these tedious cases.

CHEMISTRY OF THE CINCHONA BARKS-CINCHO-QUININE.

The chemical manipulation of the Cinchona or Peruvian barks reveals the presence in them of quite a number of most remarkable, complex bodies. No vegetable production, except the poppy, affords such a marvelous combination of valuable medicinal principles as the loxa and calisaya barks, and no substances have been studied with greater care or more intense interest by chemists. Nothing short of the subtle chemical forces controlled by the Infinite One, could construct from the elements of the earth and air a bitter principle like quinia, or those other agents associated in bark, so closely allied to it physically and chemically. A handful of the finely comminuted fibres of the yellow bark, which resembles physically a dozen other varieties, is made to yield by the chemist, when treated with aqueous and alcoholic liquids and acids, a dark, bitter solution, unattractive in taste and ap pearance. If the process is skillfully conducted, or exhaustive in its results, there remains, beside the solution, a portion of woody fibre, inert and almost tasteless. It holds considerable coloring and some waxy matter, together with a little tannin; but the active chemical or medicinal principles have been removed, and are held in the dark liquid. The exhausted bark is not entirely worthless, for it may be dried and used as fuel. But what of the dark liquid? From this the chemist obtains, beside other substances, a portion of beautiful, white, silky crystals; not wholly of one distinct kind, but of several, all of which possess about equal chemical and therapeutical importance. No wonder it seems, to the uninitiated in chemical manipulation, a difficult work to perform. It is however, quite easy to the thoroughly instructed. The first principle isolated may be quinia. This is not held in the bark in its naked alkaloidal condition, but locked up, in the form of a salt, with another principle called kinic acid. In the bark it is kinate of quinine. We isolate the quinia, tear it from its embrace with kinic acid, throw that away, force it into a kind of matrimonial alliance with sulphuric acid, and in this condition of sulphate of quinia, use it as a medicine. This kinic acid marries into several other families resident in the bark, prominent among which are cinchonia, cinchonidia, quinidia, etc. Precisely how many of these alkaloidal principles the different kinds of barks contain, is unknown; but it is safe to assume that there are as many as four others which, although not distinctly pointed out, are tolerably well recognized. These kinates are all kindred in nature, and all labor to the same end, when isolated and set to work as therapeutical agents in the human system.

In one hundred ounces of good yellow bark, we obtain about two and three-fourths ounces of quinia, and two ounces of cinchona, with variable amounts of the other principles, but less than the two named. It is to be regretted that we can not remove the different families of kinates from the bark in their natural state of saline combination. It seems reasonable to suppose their action upon the system would be