derived from other diseased parts than to disease of the meat itself. The same matter is found in the milk of cows when the udder has become invalid by tuberculous disease, and seldom or never when the udder is not diseased. Tuberculous matter in milk is exceptionally active in its operation upon animals fed either with the milk or with dairy produce derived from it. No doubt the largest part of the tuberculosis which man obtains through his food is by means of milk containing tuberculous matter. The recognition of tuberculous disease during the life of an animal is not wholly unattended with difficulty. Happily, however, it can in most cases be detected with certainty in the udders of milch cows. Provided that every part which is the seat of tuberculous matter be avoided and destroyed, and provided care be taken to save from contamination by such matter the actual meat substance of a tuberculous animal, a great deal of meat from animals affected by tuberculosis may be eaten without risk to the consumer. Ordinary processes of cooking applied to meat which has got contaminated on its surface are probably sufficient to destroy the harmful quality. They would

not avail to render wholesome any piece of meat that contained tuberculous matter in its deeper parts. In regard to milk we are aware of the preference by English people for drinking cow's milk raw-a practice attended by danger on account of possible contamination by pathogenic organisms. The boiling of milk, even for a moment, would probably be sufficient to remove the very dangerous quality of tuberculous milk. We note that your Majesty's gracious commands do not extend to inquiry or report on administrative procedures available for reducing the amount of tuberculous material in the food supplied by animals to man. and we have regarded such questions as being beyond our province."

THE CAUSES OF DEATH OF MEDICAL MEN.

It has been shown heretofore in these columns that the mortality in the medical profession is greater than either in the clerical or legal. In London, Ogle has shown that the annual mortality of the cleri

cal profession is 15.93 per thousand; of the legal 20.23, and the medical 25.53; the latter exceeded only by the saloon keepers, butchers, quarrymen and under-paid factory operatives.

Dr. J. S. Kortwright, of Brooklyn, made a study of the records of New York and Brooklyn and finds that during the years 1884 and 1892, inclusive, that of 450 physicians the average age at death was 54.6 years. In the first decade after graduation one-tenth die; in the second one-sixth; in the third one-sixth; in the fourth oneseventh; in the fifth one-fifth; in the sixth one-seventh, leaving only one in fifteen to round out the four score years.

Three per cent. of this mortality is due to suicide; a mortality four times that of other adult males. It is hard to say whether this is due to the educational acumen of professional men or to the intemperate habits (drugs and liquor) so

Bright's disease, heart disease and apoplexy, which he rightly classes as a three fold sequela of one disease. The mortality here is thirty-five per cent.

It is here that the doctor presents his argument which hardly appears tenable; it is too narrow.

To account for the degeneration of the arteries and the large mortality he says it is his conviction that it is due in greatest part to neglect of the rules of hygiene, "Therefore, when you especially diet. find your arterical tension increasing, your temporal artery becoming tortuous, your radial growing hard, especially if you have a little palpitation and pass an increased amount of limpid urine, whatever your years, know that old age is upon you. Curb your ambition; be content with a small practice; reduce your expenses; give up your night work; eat abstemiously; drink not at all; cultivate an even disposition; study to be quiet."

CORRESPONDENCE. EXPERT TESTIMONY.

OMAHA, JUNE 3d, 1895.

Dr. B. F. Crummer, Esq.

DEAR SIR-At the time you refused to testify as an expert in the case of Ely vs. Smith-Steele Grocery Company until your expert fee was paid, I was then of the opinion the court was right in holding that after you had been sworn to testify in the case you had waived your right to demand such fee before you gave expert evidence. Since then I have investigated the question and find you were right. Some of the authorities read as follows: "An expert witness, called to testify to his opinion, is entitled to compensation over and above the fees allowed other witnesses by law, and, if he refuses to testify, he cannot be committed for contempt." Another author says: "But once put upon the stand as a skilled witness, his obligations to the public now cease, and he stands in the position of any professional man consulted in relation to a subject on which his opinion is sought. It is evident that the skill and professional experience of a man are so

far his individual capital and property that he cannot be compelled to bestow them gratuitously on any party; neither the public any more than a private person have a right to extort services from him in the line of his profession without adequate. compensation. On the witness stand, precisely as in his office, his opinion may be given or withheld at pleasure: for a skilled witness cannot be compelled to give an opinion, nor be committed for contempt if he refuses to do so."

I thought perhaps you would like to have this information to guide you in the future, and therefore take the liberty of writing you on the subject.

Very truly yours,

GEO. W. COOPER. EDITOR CLINIC.-Dear Sir: In the case referred to in Mr. Cooper's letter, I had examined an injury at the suggestion of the attorney for the plaintiff in a damage

case.

When the trial came on I was summoned to appear in court and the fee for an ordinary witness $2.00 tendered me. When I refused to testify as an expert, Judge Blair, of the District Court, held that I was in contempt and that he could not fine me, but, send me to jail. I held out somewhat and the attorney withdrew his question. It seems now that I was entirely correct in refusing to testify and the point is one that I think ought to be known generally for the guidance of other physicians who may be placed in a similar position. Respectfully,

B. F. CRUMMER.

SCIENTIFIC.

The Diagnosis of Diabetes and Glycosuria by Examination of the Blood. -Dr. Bremer describes a modification of Ehrlich's method of staining cover-glass preparations of blood with eosin and methyl blue. By this method of staining, in normal blood the red blood corpuscles appear brownish red, but the color varies from a clear reddish brown to a deep chestnut brown (The British Medical Journal). The nuclei of the leucocytes stain blue. Bremer found that in diabetes and glycosuria the red blood-corpuscles either remained completely unstained, or they

were simply tinted light yellow or greenish yellow. Only occasionally a small peripheral zone of the red corpuscle was tinged slightly red. Other minor changes were found in the leucocytes. With acid fuchsine and other so-called acid dyes, the red corpuscles of diabetic blood stained just in the same manner as those of normal blood. It was only eosin which did not stain them. In order to determine whether this loss of staining affinity for eosin was due to the abnormal amount or sugar in diabetic blood, Bremer treated cover-glass preparations of normal blood with a solution of sugar. But he found that the red corpuscles still stained with eosin, as in normal blood. If, however, a cover-glass preparation of non-diabetic blood was floated for twenty-five to thirty minutes in a diabetic urine, the red corpuscles failed to stain brownish red with eosin; they remained unstained or were only slightly. tinted yellow or greenish yellow, as in diabetic blood. But the red corpuscles in a cover-glass preparation of non-diabetic blood, treated with urine free from sugar, stained with red eosin. In glycosuria produced artificially by the administration of phloroglucin for three days, the red corpuscles failed to stain with eosin, as in diabetes.-New York Medical Record.

The Rapidity of Reproduction of the Uterine Mucosa in Women After Curettement.-Bossi (Annali di Ostetrica e Gynecologia, February, 1895, No. 2), after a series of observations and experiments made upon the uterine mucous membrane in women, with a comparative study of the same tissue in the dog to determine the rapidity of reproduction after curettement, formulates the following conclusions: (1) He found in two women upon whom it was necessary, twenty-five and twenty-seven days respectively, after curettement to do hysterectomy, a reproduction of the uterine mucous membrane histologically complete. (2) In a woman upon whom hysterectomy had to be performed fifteen days after curettement the uterine mucosa was found practically entirely reproduced, there being found, for some inappreciable cause, here and there tracts of deficient epithelial reproduction. (3) In seven cases under clinical observation, it was noted that the mucous membrane of the uterus was capa

ble of permitting the development of a fecundated ovum in the limits of a minimum of twenty-five days to a maximum of twenty-nine days after the curettage: After that number of days, in each of the seven patients, fecundation took place, followed by pregnancy and birth at term, with an uneventful puerperium, Bossi states, however, notwithstanding this, that a complete sexual rest of at least sixty days should be prescribed after all curettements. For while the uterine mucous membrane is capable of fulfilling its physiological function of protecting and enveloping the fecundated ovum after the comparatively short time noted in his observations, yet there is always an element of danger in a pregnancy that follows a curettement of less than sixty days. There is in the reproduced uterine epithelium a condition of lessened resistance that leaves it more at the mercy of any intercurrent pathological condition or sudden traumatism.-University Medical Magazine.

Prostitutes and Pus-Tubes. It is very widely maintained among gynecologists that tubal abscesses are in a large measure traceable to the existence of previous gonorrhea on the part of the husband (Medical Record). It is not uncommon for surgeons to contend that this condition is to be traced back to gonorrheas that have passed away years before marriage. They insist that gonococcus has been hiding away all that time in some quiet re ceptacle, only to come out and in the light of the honeymoon invade the uterus and tubes of the unsuspecting bride. If this contention be true, prostitutes who ply their trade more than two or three years ought not to possess healthy ovaries, for it is the rarest thing for them to escape having in that time two or more attacks of gonorrhea. Yet, as far as impressions from our reading and personal observations go, they are strong that the number of operations on account of salpingitis among prostitute is disproportionately small; and this, notwithstanding the fact that the temptation is great for those who would gain experience to operate on this class of patients. It would be interesting to know what proportion of cases of pus-tubes are found respectively in chaste women and in prostitutes. St. Louis Medical and Surgical Journal.

Changes in the Blood During Antisyphilitic Treatment.-J. Justus (Wiener Klinische Rundschau, February, 1895), at a meeting of the Royal Medical Society at Budapest, took the view that the hæmoglobin of the blood is reduced in quantity at the beginning of the antisyphilitic treatment, but that later it is increased, so that ultimately there is more hæmoglobin present than before the treatment was commenced. As soon as there is an increase of hæmoglobin the syphilitic condition. improves. Following out these investigations, he finds that in non-syphilitic individuals the use of mercurials is not followed by any such results. To demonstrate this, he reported the results obtained in the examination of the blood in 140 non-syphilitic cases. The specific gravity of the blood is not changed by the administration of mercurials, which shows that there is no thinning of the blood; on the contrary, the urobilin appears in the urine, showing the presence of hæmoglobin in the blood-i. e., there is some destruction of red blood corpuscles. This was demonstrated by the microscopic examination.

He concludes by stating that in his opinion the mercury destroys those blood corpuscles which are affected by the syphilitic infection. -Medicine.

On the care of the Ear during the Course of the Exanthemata.-Walker Downie, M. D. (Journal of Laryngology, Rhinology and Otology) states that of 404 cases of otitis media suppurativa in children the cause in about 60 per cent. was fairly determined to have been measles, scarlet fever, whooping-cough, mumps or teething.

From the very beginning of the illness, where there are any catarrhal symptoms, the patient should be directed to use the handkerchief frequently and strongly, the object being to clear the nose and nasopharynx of muco-purulent products and so prevent them from settling and decomposing around the eustachian orifices, through which infection of the ears takes place. If the child cannot do this efficiently, the Politzer inflation-bag should be used. The quantity of secretion dislodged and thrown into the mouth by this means is astonishing. When there is dullness of hearing or pain in the ears, resort to inflation should never be delayed.

When the pain in the ear is acute, and should immediate relief not be obtained from inflation, and especially if there is a sudden rise of temperature without other explanation, the tympanum should be punctured without delay. Have the head securely held; have the membrane brightly illuminated; use an arrow-shaped paracentesis knife with a shoulder; puncture the tympanic membrane in its lower and posterior part. The operation not only relieves the immediate pain, but saves the deeper structures of the ear and prevents the misery of a chronic otorrhoea with its attendant risks.-Medicine.

The danger of Apoplexy from Ether Narcosis. Some time ago Singer reported a case of death from apoplexy following ether narcosis, and suggested that unless there were some other contra-indication, chloroform should be preferred in subjects when arterio-sclerosis was present or presumable. Now Quervain (Centralblatt f Chirurgie, 17, 1895) reports another case with a similar conclusion. In this case the patient was a corpulent, but anaemic woman, aged 42, who, five hours after an operation lasting four hours, gradually became hemipligic and died on the fifth day. There was nothing unusual about the narcosis except that the stage of excitement was strongly marked. The ether was of the purest. This case and · Singer's may have been mere coincidences, but it is easy to see how a remedy which increases the blood pressure as ether does, might in a predisposed subject cause the rupture of a blood vessel.

Local Anesthesia as a Guide in the Diagnosis of Lesions of the Upper Portion of the Spinal Cord. In the Autumn number of Brain Dr. M. Allen Starr, of New York, contributes a valuable and interesting article upon the above topic.

Incidentally attention is called to the fact that the nerve roots originate by fibres which extend an inch or two both above and below the point of exit, and that therefore a lesion of considerable vertical extent is necessary in order that it shall shall produce complete paralysis of any given muscle, and further the experiments of Sherrington are

quoted as showing that in the monkey it is necessary to divide three sensory posterior nerve roots in order to produce complete anesthesia in a part, thus showing that there is some overlapping of the areas of supply and at the same time accounting for the fact that the upper border of the anesthetic area shades off somewhat gradually and is well below the lesion in the cord and lastly that the relation of the cervical segments in the cord to the spines and bodies of the vertebræ are not

constant.

The minute history of numerous cases is presented and from these the following deductions are made:

The first dorsal segment corresponds to a narrow area of anesthesia on the inner side of the arm and forearm and stopping at the wrist. The eighth cervical segment corresponds to an area including dorsal and palmar aspect of ths ulnar sides of the hand to the middle of the ring finger and also a narrow strip of skin on the dorsal and palmar surfaces of the arm adjacent to the preceding and extending up to the axilla. The seventh cervical segment corresponds to a zone extending to the middle line of the middle finger including the middle of the paim, back of the hand and running up the center of the arm and forearm and both surfaces. The sixth cervical segment corresponds to a zone including the remaining skin of the hand, fingers and thumb and a narrow strip of skin up the forearm and arm on both surfaces as far as the axilla. The fifth cervical segment corresponds to a zone on the outer side of the arm and forearm on both surfaces as high as the insertion of the deltoid muscle.

Lesions above the fifth cervical segment are uniformly fatal and therefore the extent of skin corresponding to the segments above this point cannot be determined.

The cilio-spinal centre is situated in the first dorsal segment and when it is injured there is sluggish reaction of the pupil both to light and accommodation, myosis, a decided narrowing of the palpebral fissure, so that the eyeball looks smaller than normal and a slight retraction of the eyeball. These symptoms are often overlooked and all the more readily when they are bilateral, as usually happens.

While Dr. Starr attaches considerable

scientific importance to his work he says that the statements commonly met with in the text books, as to the symptoms resulting from a lesion of the upper, middle or lower part of the cervical enlargement are accurate enough for practical use.

Uric Acid Diathesis. In a recent paper upon this subject, Dr. John F. Barbour very aptly remarks: "Uric acid has now come to be regarded as one of the great poisons, fully comparable in its evil effects upon the human body to syphilis and tuberculosis, but far more insidious and slow in its action than either of these." We entirely agree with Dr. Barbour in his startling statement. It is remarkable that, notwithstanding the fact that uric acid is thus regarded by those members of the profession who have made a careful study of this subject, and have, by experience, learned their inability to cope with chronic disease in many of its forms without a recognition of the important relation of this toxic agent to many pathological conditions, so little is said and done in relation to the prevention of this hydra-headed malady,-uric acid intoxication.

We may properly summarize a few of the interesting facts bearing upon this subject, which are admirably presented by Dr. Barbour in his excellent paper:

Vigouroux asserts that neurasthenia is of gastric origin, and adds: "All neurasthenic patients, without exception, are arthritics. * * * There is no distinction to be made between those affected with simple neurasthenia and the neuroarthritics. The word 'neurasthenia' of itself implies the idea of arthritism."

Bouchard asserts that the uric acid diathesis is one in which there is a retarded nutrition, or insufficient disassimilation; a pathological state which exists under the following conditions:

''I. When, after the ingestion of a certain amount of food, the organism requires a considerably longer time to return to its original weight than is required in the normal state.

"3. When the weight of the body increases under the normal amount of food. "4. When, under the living ration, the amount of excreta is less than normal.

"5. When, during abstinence, the dim