and in all cases that are incapable of reaction. Thus, old people and the subjects of arteriosclerosis, or interstitial nephritis are not good subjects for this method of treatment. (British Medical Journal, Feb. 8th.)

THE

A NEW METHOD OF CLOSING VESICO-VAGINAL FISTULA. HE Philadelphia Medical Journal, Feb. 15th., has an article by Dr. A. Lapthorn Smith, of Montreal, describing a new and improved method of closing a vesico-vaginal fistula, with report of a case. Briefly the procedure was as follows: After careful disinfection the bladder was separated from the uterus and vagina, the laceration in the uterus was closed by Emmet's method with chromicised cat-gut; the edges of the tear in the bladder wall were brought together, the margins being freshened in the separation; and the muscular walls were brought together by an over and over chromicised cat-gut suture going back fully an eighth of an inch on each side, but without penetration of the mucus membrane, in this way a strong ridge was made; next the slit in the vagina was closed by an interrupted silk worm gut passed through the vagina then through the muscular wall of the bladder, but half an inch to the left, so that the bladder was displaced sideways, and the line of the two rows of sutures was separated by an interval, thus opposing a valve to the escape of the contents. A catheter-à demeure was placed in the urethra ; the stitches were removed on the tenth day, and the result was an uneventful and permanent cure

The surgeon emphasises the importance of the avoidance of penetration of the bladder membrane, thus avoiding the possibility of the formation of calculi on the sutures; the inclusion of enough of tissue in the suture to ensure the presence of a thick ridge, and the displacement of the two lines of sutures, as an additional safeguard against leakage.

NAKED-EYE DIAGNOSIS OF STOMACH DISPLACEMENTS. N the New York Medical Journal, Feb. 15th, Dr. Knapp calls attention to the possibility of locating the stomach curve and the lines of other organs, by the naked eye. The patient's abdomen is bared, the examiner stands either at the side or shoulder of the patient so as to look down towards him, the eye is then brought on a level with the surface of the body and the abdominal respiration is watched with one eye or both, when the curvatures of the stomach will be seen distinctly as fine lines under the skin, moving with the respiration. These may be marked with ink and their position verified by percussion. The same method may be applied to the location of the enlarged spleen or other organ.

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Royal University, Leyden,

Jan., 1901.

PROFESSOR DR. ROSENSTEIN

Employed at "Royal Victoria" and "Montreal General" Hospitals.

SEE that the Label bears the name of The Apollinaris Co., Ld., London Sub-Agents in Canada, WALTER R. WONHAM & SONS, MONTREAL.

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MANUFACTURING CHEMISTS AND BIOLOGISTS

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WALKERVILLE, ONT.

No. 7.

VOL. XXXV.

MARCH, 1902.

EDITORIAL.

OPERATION FOR MITRAL STENOSIS.

PPARENTLY the end is not yet. Sir Lauder Brimton contributes to

THE LANCET a preliminary note on the possibility of treating mitral stenosis by surgical methods. The condition is so distressing and so little amenable to medical treatment that he thinks dividing the constriction should be considered as a possible surgical procedure to afford relief. While appreciating the dangers attending such an operation, the risk of a shortened life might well be balanced against the continuance of a condition worse than death. Sir Lauder very properly says that no one would be justified in attempting this operation on a fellow creature without first experimenting on animals. He accordingly procured a license to make the necessary experiments but so far he has not been able to carry them out. The distinguished author would probably have been wise to have deferred writing until he had put himself in possession of some clinical or experimental data to commend his suggestions to the profession.

Is not the argument that a certain condition is irremediable by medical treatment too frequently put forth as a reason for undertaking certain surgical measures often immediately hazardous and offering scarcely the faintest chance of giving relief? Surgical interference should have more to commend it than that the patient's condition is distressing, or even hopeless, under medical treatment. There should be a well grounded hope at least of relieving the condition for which the operation is undertaken. The surgeon should not be asked to play the role of executioner-even in desperate cases. We hope something good may come of Sir Lauder's suggestion, but we believe an excellent rule has been violated by going into print before having something definite to say.

CHRONIC PENTOSURIA.

This is an obscure condition wherein a substance appears in the urine which reacts with Fehling's test and with phenyl-hydrazin in much

the same manner as glucose, consequently giving rise to a possibility of mistaking pentosuria for glycosuria. It differs from the latter, however, in not responding to the fermentation test. Neither does the administration of glucose to patients suffering from the condition, cause any increase of the substance in the urine nor yet produce a glycosuria, so that it evidently bears no relation to diabetes. No alteration in the condition can be produced by variations in diet. The etiology of pentosuria is not understood as only a few cases have been studied and reported. Bial & Blumenthal, who have reported a case, say that in normal tissue metabolism a certain amount of pentose is formed from the nuclein of the tissues, but this is rapidly oxidized and does not appear in the blood or urine. Under other circumstances not yet understood this process of complete oxidation fails and the pentosuria appears. The chief practical importance attaching to it is the liability to mistake it for glycosuria, its true clinical significance being as yet unknown.

EDITORIAL NOTES.

DR. R. S. A. KNOPF, of New York, the specialist in tuberculosis,

has written a very kind letter in appreciation of the two excellent Tuberculosis numbers of THE CANADA LANCET. The congratulatory letters now received from all parts of the country show that the improvements in this publication are much appreciated by the profession. Not one half of the projected improvements have yet been made, because time is required to work out the details of the scheme now in hand. New departments and new features will be added from month to month, until THE CANADA LANCET is the equal of any medical monthly in the world. Ther is no reason why this country, with its excellent colleges and its high standard of professional training, should not have a journal which will truly represent the medical profession. THE CANADA LANCET now circulates in every province in Canada, two hundred new subscribers having recently been added from Manitoba, the North-West and British Columbia. It hopes, by a consistent and broad-minded editorial policy, to retain the good-will and respect of every member of the Canadian profession, no matter what his college affiliations or his special line of work. It asks no more than to be judged by the standard it maintains.

June 4th and 5th have been fixed as the dates of the next meeting of The Ontario Medical Association in Toronto. Dr. J. T. Fotheringham has been chosen as chairman of the Committee on Papers and Business, and has associated with him a number of active workers. This committee