the right lumber region, about the size and shape of a lemon. The heart, lungs, and urine are quite healthy, bowels constipated, catamenia regular. She is occasionally troubled with vomiting, which greatly distresses her." In some remarks on the case we find as follows: "The right kidney, from its position, is more favorable for recognition when the organ is movable than the left, as the left kidney is liable to be mistaken for the spleen." A movable kidney is now a recognized phenomenon in medicine, several undoubted cases having been made out during life."

5th. In same journal, for 1863, page 470, we find a report of a case of movable kidney of left side: Charring-Cross Hospital. "In this case it was a woman, aged twenty-five, married, but without children. Had been ailing, more or less for twelve years. Two years before, she was told by medical men she had a movable kidney. From the report of this case, there was undoubted organic disease of the organ, as the patient was very sick at times, and the tumor enlarged, with difficulty in passing urine, and then a feeling as though something broke in her side, followed by a free passage of urine, and has something like blood in it.'

6th. In same journal for 1864, page 122, there is a report of a case of extreme mobility of both kidneys, in a woman, aged 42, married, mother of ten children. For ten years the patient had felt a tumor in right side as large as a turkey's egg, and within the last few years she became aware that a similar tumor existed in the left side. On examination, a tumor was easily discovered in each lumbor region upon relaxation of the abdominal muscles.

The urine was healthy, but the patient was nervous and apprehensive of her condition. The report closes: "The case forcibly exemplifies the importance of recognizing this condition, and the rapidity with which an improvement may occur in highly nervous person, whose mind has become relieved, having been previously occupied with forebodings of ill."

7th. Same journal, for July, 1869, page 379, Dr. Duffin reports a case of floating kidney: " Female, aged 37, whose right kidney is movable. The discovery was made quite accidentally, as the patient applied for hysterical symptoms, not connected with the urinary organs."

I will not quote from the report further, except to say that out of thirty-five cases collected by Dr. Fritz, of Paris, thirty were in females, and that floating kidney is most common on the right side.

From the brief extracts of the cases noted above, it will be seen that as a rule the displaced kidney does not give rise to any serious disturbance, either of the renal organs or of the general system, but in case 7th, reported above, was somewhat similar to our patient when first seen by me, February 23, 1875.

The greater frequency of the right kidney being displaced, as well as its being more frequent in females than in males, is a well recognized and undisputed fact, but the reasons for the same are not so well explained.

My own opinion, from the study of the subject, is that after frequent child bearing the muscles of the abdomen become relaxed, and there is a greater amount of adipose tissue in the abdominal walls, than in men, which would tend to weaken them, and the fact that the brim of the pelvic cavity is broader in women than in men, would have a tendency to allow the organs contained in the abdominal cavity to descend lower. And that tight lacing in women has a great tendency to press the organs downwards, would naturally press the kidneys away from their place, and also that the right kidney lies lower in the lumbar region than the left. It would, therefore, be more easily displaced, and the organs when once loosened from their attachments can then float in any direction downwards, forwards or sideways, as far as the ureters will allow.

I could have extended this paper at a much greater length, but the above will be sufficient to call your attention to this subject, and may thus enable you to detect and diagnose the cause, when having a troublesome case of a tumor floating in the abdominal cavity.

Translations.

Diseases of the Skin.

Therapeutic Notes gathered at the Clinic for Cutaneous Diseases of Prof. Hardy, at the Hospital St. Louis. By Dr. E. ORY, Intern of Hospital.

Treatment of Cutaneous Hyperesthesias.

In this group, altogether artificial, of cutaneous hyperæsthesias, we propose to gather several species of cutaneous

affections, diverse in their origin, but presenting all, to a very high degree, one common and very painful symptom: Hyperæsthesia. For example, the various prurigo, strophulus simplex, strophulus pruriginosus, the hyperesthesia of Icterus, then Zona, urticaria, and even chillblains.

The cutaneous hyperesthesia may be the cause of profound trouble in the economy; furthermore it presents itself for our observations under the most diverse conditions. At times this painful symptom will be limited to a circumscribed region, the palms of the hands, the plantar surface of the feet, around the anus, or the genital parts. Again, it may be found generalized over the whole body, causing the patient to scratch and provoking prolonged insomnia. The cutaneous hyperesthesia is often dependant upon uncleanliness, upon alcoholic excesses, upon a general debilitated state of the economy from age or poverty, or from disturbance of the gastro-intestinal functions. Developed, maintained by the presence of parasites, we see it often persist for a long time after the disappearance of the parasites, constituting thus, alone, the malady, but demanding nevertheless energetic interference, as it has a great tendency to become chronic. It is necessary to interfere before the malady, prolonged in continuance for months or years, has become rebellious against all therapeutic agents; a thing particularly to be feared in pruritus of the genitals.

Pruritus of the genital parts (prurigo pudendi muliebris) excites irresistible itching which forces the patients to scratch; it can thus among other consequences determine the most vicious habits that will persist even after the disappearance of the malady.

Neglect of proper cleanliness being one of the predisposing causes, the first thing to be advised is frequent baths. Then M. Hardy prescribes lotions of alum, of lead water, and above all of the sublimate.

This is the manner the lotions of hydrarg. sublimat. are to be used. Put into a glassful of warm water a teaspoonful of the following solution:

This application should be repeated several times a day. A similar treatment may be advised for the prurigo of the scrotum and the prurigo of the anus; it is, however, well

known that this latter affection is very often rebellious against all treatment, especially if in the old or in exhausted subjects. To calm the itching arising from Intertrigo I have often heard Prof. Hardy prescribe the following liquid:

This lotion is to be applied twice a day to the diseased part. At other times the cutaneous hyperesthesia is generalized over the whole body; it is this form that is met with in certain old persons who have been afflicted with, and cured of, parasitic affections or general eczema. Numerous excoriations caused by incessant scratching; insomnia and the debility resulting from the want of perfect sleep; nervous irritibility; such are some of the consequences resulting from the cutaneous hyperesthesia. We must therefore use our best endeavors to calm this irritability, in order to remove the disorders resulting therefrom.

For this purpose M. Hardy frequently uses a milk of sulphur. Here the formula:

The patient is washed twice a day with this sulphur milk, which very quickly brings about a diminution of the itching. Besides this we may direct the patient to wash himself morning and evening with the following mixture:

Where fresh almonds can not be obtained, the sulphur can be added to a looch; good results have been obtained with the following formula:

This mixture is to be applied twice a day. These calming lotions, very useful in combatting the cutaneous hyperæsthesia subsequent to parasitic affections or eczema, are equally useful in senile pruritis, which is a veritable neurosis.

The Strophulus pruriginosus, with papular eruption, the seat of very severy itching, comes truly under the group of maladies, the treatment of which we are now considering. This is a disease that persists for months, and has a tendency to relapse, especially during the hot months. The role played by bad hygienic surroundings, in favoring its production, is a marked indication for the physician that the first thing to be done in these cases is to improve the hygiene of the patient. Rooms very much exposed to the sun, and in which a large number of persons sleep, rather crowded, wherein the air is renewed with difficulty, such are the conditions in whose midst the Strophulus appears. Frequent out door exercise, change of dwelling, frequently suffice to cause the eruption to disappear in a few days; success is however generally mementary; relapses are very frequent. Therefore M. Hardy, not content with watching the habitat of the patient, with ameliorating his hygiene in general, prescribes also tonics to tone up his general system. Iron, quinine, cod liver oil, sulphur baths, bitter infusions, and if possible, a removal from the city and a stay in the fresh air of the country, are the treatment addressed to the general system.

The local treatment, the importance of which is by no means so great, as the above mentioned general one, consists of frequent baths, alkaline or sulphurous, and applications of a powder, composed as follows:

R. Powder of Wheat Starch (amyli), 3 parts.

Oxide of Zinc,
M.

1 part.

Another form of strophulus, and this one very frequent in infants, the Strophulus Simplex, appears about the period of dentition, or if at a later period is generally coincident with some gastric embarassment.

In this latter form a mild purgative may perhaps be advantageously prescribed, but generally, active treatment is out of place. Cooling drinks, the application of the pulvis amyli or lycopodium suffice to calm the itching that accompanies this mild form of strophulus.

In the cases where the prurigo is due to nervous influence, if it be thus a neurosis, the calming lotions indicated above,