pigs, and sheep, and then usually in young animals, from licking one another. These balls have been found in the manger, having been brought up in the process of rumination, and dropped out of the mouth. These masses are called bezoars, or, if composed entirely of hair, trichobezoars. My patient declares she has never swallowed her hair, and I would not consider her hysterical. There is no doubt, of course, that she did swallow this hair. Her temperature never reached 100 after the operation, and was normal after the first three days. Pulse went up to 120 immediately after the operation, but in 24 hours was 110, and in three days was 80, and remained about this until she left the hospital. One of the most interesting and remarkable features of the case was the entire absence of symptoms pointing to any disturbance in the stomach. It is now three months since the operation, and she is enjoying the best of health. In the Medical News of February 16th, 1901, Dr. Nathan Jacobson, of Syracuse, reports a case very similar to mine. His patient was a girl, eleven years of age. Unlike my case, she had evidences of gastric disturbance for about a year before the operation, such as the vomiting of frothy mucous, and had a considerable amount of colicky pains in the stomach. The photograph of the hair mass removed, which he calls a hair-cast, shows it to be very similar in shape to the one I am presenting. It is smaller, however, weighing 15 oz. His patient admitted that she had been in the habit of biting off the ends of her hair, from the earliest years of her life. At first she thinks she did it simply because she was nervous, but later she rather liked the tickling sensation produced by the hair in its transit to the stomach. Dr. Jacobson, in reviewing the literature, finds 19 authentic cases where the patients have swallowed a sufficient quantity of hair to create within the stomach a hair-tumor. Only one of these was a male. Dr. W. G. Brewster, in the Boston Medical and Surgical Journal, reports a case in which an accumulation of hair became lodged in the small intestines, and produced intestinal obstruction. The patient, a girl of ten, survived the operation of enterotomy only five hours. The youngest patient was 10, the oldest 34. None of these patients were insane, and but few sufficiently nervous to be described as hysterical. In nearly every instance the habit of hair-swallowing was of years' continuance. In one case it had existed for 13 years, in another 15, 17 in a third, and 22 in a fourth. The stomach became gradually accustomed to the presence of the foreign body, and in many instances tolerated it without the slightest rebellion. The largest mass of hair removed from the stomach, on record, is one weighing 5 lbs. 3 oz. Of the 19 cases, 10 were discovered post-mortem, and 9 upon the operating table. It is surprising that the discovery of the hair-cast was very unexpected. In not a single case had a correct diagnosis been made, and no physician or surgeon surmised that he had to deal with a foreign body in the stomach. As a rule the diagnosis was splenic or omental tumor, movable kidney, or faecal or cther impaction in the transverse colon. As a rule the hairs had simply been bitten off the ends of braids or flowing locks, but in other instances hairs of great length were found. One woman was said to have pulled the hair out of the back of her head whenever she became nervous, rolling it up into a ball and swallowing it, while another deliberately swallowed her combings night and morning. Croup. The preparations of lobelia are very valuable from a therapeutic point of view. A few days ago I treated a very bad case of croup, in a child fourteen months old, with acetic emetic tincture every fifteen minutes, and the emetic powder on a larded cloth applied to the throat and chest. The father said he could hear the child's efforts at respiration at the stable, which was fifty feet at the rear of the house, the windows of the house being closed. After a few doses of the acetic emetic tincture the child was relieved, and made a good recovery.-Ec. Review. An Ointment for Psoriasis. Morgenstern (Therapie der Gegenwart, 1901, No. 6; Fortschritte der Medicin, August 15th) recommends this formula: it was Infusion of sage is again recommended for the treatment of hyperidrosis in tuberculous subjects as well as those suffering from leukæmia, rheumatic polyarthritis and typhoid fever; in thirty-eight cases where tried there were only two failures. Steep forty-five grains of sage leaves in half a pint of water and let the patient take a cupful in the morning, one during the course of the day, and still another before retiring at night-or the tincture of the leaves may be given in twentydrop doses in the morning, and from twenty to forty drops at night. Salvia officinalis has a proper place in the front ranks of anti-sudorific remedies.-Medical Week. WI BY A. C. LAMBERT, M. D., C. M. (TRIN.) Late Surgeon R. M.S." Empress of China." ITH auother serious outbreak of Bubonic Plague in Hong Kong this year, and with every prospect of a repetition of the same next summer it is very essential, in view of the increasing tide of Chinese immigration to Canada, that the profession and public understand thoroughly the extreme danger which menaces them of having, sooner or later, to wrestle with the disease on their own shores, as their sister Colonies of Australia and the Cape have already been forced to do. It is not with the intention of questioning the present methods employed by the Canadian Government at their Western Quarantine station at William's Head, Vancouver Island, that I have ventured to discuss this subject. Nothing could be more thorough and effectual than the superheated steam and formaldehyde disinfectors, which constitute,with bichloride baths for the passengers, the principal appliances in use at William's Head; and no one could be more painstaking and energetic in the discharge of his sometimes not altogether pleasant duties, than is Dr. Watt, Inspector of Quarantines for British Columbia and Superintendent of the above station. The procedures are rational enough and undoubtedly accomplish the work required of them, i. e. the destruction of all forms of bacterial and parasitic life, but it is my contention that all this disinfection and fumigation are employed at the wrong end-at Canadian ports instead of at ports of departure in China or Japan. And it is this application of excellent methods at the wrong end which constitutes, to my mind, the weak point in our armor of quarantine, through which the plague is go ing to strike us. And why ? Before answering this natural query, perhaps a very brief resumé of the several epidemics of plague in South China might be of interest. There have been three serious epidemics of plague in Hong Kong, Canton and the surrounding districts. The first was in 1894, the second in 1896 and the third during the present year 1901. During the intervals between these severe epidemics plague has not been entirely absent from South China, although the number of cases occurring yearly has varied considerably. When not epidemic, it is practically endemic. Plague is not diminishing in Hong Kong and its vicinity, owing to various causes, some of them perhaps errors of judgement on the part of Colonial Administrators, others natural but difficult to remedy, such as the emigration of rats from destroyed buildings to others in the vicinity; or the ever-spreading Chinese population, which is begining to break from the confines of the native quarter and over-flow into districts hitherto occupied by Europeans only; of the presence but some hundred miles distant of that huge Celestial rabbit-warren, Canton, with its easy connection by water with Hong Kong and the resultant large and lucrative trade, difficult enough to supervise and impossible to abolish. without signing the death warrant of Hong Kong as a trade centre. With all these causes severally and collectively reacting against any scheme of sanitary reform, bubonic plague is gradually but certainly gathering the whole of this ill-fated colony into its grasp, and is beginning to take its toll of victims from the ranks of Europeans and non-Chinese residents, as remorselessly as it does from the natives. Houses, hotels and places of business in every quarter of the colony are being closed by the authorities on account of cases occurring therein, while hundreds of natives are leaving the colony in fear. With this state of affairs on shore, our Canadian Steamship Companies are filling their steerages as full as they can legally be filled with Chinese emigrants drawn solely from the towns in which plague is raging most virulently. To give them their due, the above companies do endeavor to prevent any sick or suspiciously unhealthy person from travelling on their ships, and to this end institute a searching examination, often two or three times repeated after intervals of a few hours, of all native passengers and sailors. The examination is conducted by medical men resident in the colony and having much experience in tropical disorders. The passengers and crew are usually under medical observation for about twenty-four hours before the vessel departs on her voyage and no shore liberty is allowed from the time the inspection begins. This method certainly reduces the chances of infectious diseases breaking out on board the vessel during the voyage, but the reduction is very slight. Should any infected persons in whom the period of incubation was not completed before the vessel sailed, and were therefore passed as healthy by the examining physicians, be on board, it is almost a dead certainty that the case or cases will develop before the vessel leaves her last Japanese port, and the resultant detention and disinfection will take place in that country, and by the time she reaches Canadian shores all danger will be over; and, as the Japanese are very thorough in their methods of disinfection, she could proceed without further detention provided no further cases had developed en route as it would be at least ten days, and generally more, since she left the last port to proceed on her 4,000 miles across the Pacific Ocean. This is not a case in which danger menaces the Canadian community. Let us, however, take a suppositious, but not at all unlikely case. We will suppose that amongst the crowd of some three hundred odd |