437 antidotal processes ? These considerations seem to offcr us a hint of the explanation of the intermittency in functional neuroses. The bearing of this view on treatment is as follows : First, instead of vaguely expecting help from structural anatomy to show him the pathology and treatment of this difficult class of diseases, and meanwhile choosing his remedies according to the old empirical methods, the physician should look for aid from the knowledge of the chemistry of diet ; second,

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... o-intestinal antisepsis should be studied as a particular branch of therapeutics. Lastly, the investigation of leucomaines, of which lithasmic states are an example, is of equal importance in a great variety of morbid states with functional disturbances. Directed by these three principles, suggested by the progress of organic chemistry, Dr. Thomson thinks that the treatment of functional diseases would be much more effectual than if we continue to seek for mere drugs with specific properties or to wait fruitlessly the verdict of pathological anatomy. Hill, has been fined I at the West London Police Court for not sending a notice or I certificate to the medical officer of health-as required by the fifty-fifth section of the Public Health (London) Act-in the case of JohnWeston, aged fifteen, who was suffering from diph-s theria. Mr. Blanco White said the result was that for five r days the premises were not disinfected. Mr. Curtis Bennett i said that two notices were necessary, one for the hospital authorities and one for the medical officer of health. The medical man ought to have sent the notice himself as required by the Act. The magistrate regarded the fault of Dr. Batten as due to carelessness and not wilful negligence, and imposed a fine of only 10s. with 12s. costs. A report of the case is published in another column. RUPTURE OF THE INTESTINE. CASES of injury to the abdomen in which laparotomy has si been performed for rupture of the intestine without external w wound are as yet so few in number that a record of each is is important. The diagnosis is usually so difficult that the o: surgeon hesitates to open the abdomen for fear he may be t] mistaken and subject the patient to what may prove to have a been an unnecessary operation. Yet if the intestine be rup-p tured certain death will ensue without operation, and n operation will probably not be of avail should it be t deferred until the onset of septic peritonitis. A patient aged twenty-four was admitted to St. Thomas's Hos-I pital on the 10th inst. suffering from the effects of f a kick in the lower abdomen from a horse. He was r suffering from shock, and had an anxious expression and pale c face; he lay on his right side with his thighs flexed, com-i plained of pain in the abdomen, and vomited frequently. The t abdomen was excessively hard and very tender, moved very i little with respiration, and on percussion was found to be t quite dull over the anterior part. Urine was expelled < through a catheter with some force and was quite normal. A faint bluish discolouration over the left rectus muscle indicated the part struck by the hoof of the horse. A probable rupture of intestine with rupture of omentum : or mesentery was diagnosed and operation was decided on when he had rallied somewhat from the shock. About six hours after the infliction of the injury Mr. Battle performed median abdominal section, the incision extending a short distance above the umbilicus. Much blood was found in the peritoneal cavity, and there were three complete transverse ruptures of the small intestine with lacerations of the mesentery. The extent of the injuries necessitated excision of about thirteen inches of intestine with a good deal of mesentery. After the resection there were two lesions of intestine to be united. This was done by means of Senn's bone plates ; in one instance the lateral method was employed, in the other end to end. During the operation, which was necessarily a prolonged one, it was found advisable to transfuse with saline solution, and great improvement resulted. The abdomen was irrigated and drained. With the exception of some vomiting, the cause of which was not apparent, progress was good until 7 P.M. of the 15th inst., when the patient had acute pain in the abdomen, with shock and vomiting. As this was supposed to be due to the giving way of a, stitch and the consequent escape of intestinal contents leading to peritonitis, the wound was opened and extended. This diagnosis unfortunately proved to be correct, and the parts which had been united end to end, gave way as the intestine was brought up to the surface. An artificial anus was rapidly formed through a new incision, the peritoneum washed out and the median wound closed, a glass drainagetube being inserted. The patient did not rally from the shock and died at 5 A.11. of the 16th inst. At the post-mortem examination it was found that the first rupture had taken place about twelve inches from the duodenum and the second point of union was thirteen inches beyond that. The edges : where the rupture had taken place looked somewhat dusky : and the vitality was low-a fact not surprising when the . severity of the contusion and the extensive damage to the t mesentery are considered. We hope to be enabled to publish ; in a future issue a detailed account of the case. INFLUENCE OF MIND ON BODY. IN another column we publish an interesting and suggestive paper-a paper full of "wise saws and modern instances "-by Dr. Dale. In this is illustrated on the one hand the production of disease by psychical disturbance, and on the other the cure of what may be called morbid conditions by some profound mental effect. The efficacy of strong emotion in producing, or in helping to produce, such conditions as diabetes, chorea, and epilepsy is well recognised, and we venture to say undoubted ; but it is always difficult to estimate correctly the influence of such accidents, or to say how much may be due to them and how much to an underlying instability which such a disturbance merely makes evident. That a depressed physical and mental condition also renders the bodily organs more susceptible to the influence of some poison, such as that of the specific fevers, is well recognised, and when the inseparable connexion between mind and body and the profound alterations which fear or joy bring about in, for example, secretory organs are taken into account it is not surprising that violent emotion should, as it were, open the gate to allow the admission of sundry toxic influences. It is an interesting question how much of the general-but by no means invariable-immunity which medical men enjoy from infectious disease is due to the calmness and unconcern with which they regard such diseases in relation to themselves. They forget to be afraid, and so they are clothed with an invisible and often an invulnerable cloak. The influence of mental effort in overcoming diseased conditions is not so well authenticated. The instances which Dr. Dale adduces are for the most part socalled hysterical conditions, and it is open to doubt how , much such conditions have underlying them any actual ! change in structure. The helpless and paralysed lady who is : frightened into activity by the threat of a drunken man : to kiss her is a familiar type, but that of the man who i reasoned himself out of an attack of hydrophobia is not so icommon, and would certainly require careful looking into. Of the efficacy of music and the "influence of sweet sounds" in producing that feeling of restfulness and comr fort which is so conducive to recovery from any morbid state