water-borne. The drinking water at this time of year should be subjected to frequent analysis. The laity should be instructed in the fact that because water is clear and palatable is no reason why it should be free from germ contamination. But while typhoid fever is usually due to the introduction of the germ into the system in the water or food, it should be remembered that a vulnerable foci in the intestinal mucosa is necessary for infection to take place. The prevention from a subjective standpoint is therefore imperative. See that every organ and function are normal, and that elimination is perfect. This being true typhoid infection is rare. In hot weather give the babies water each time before nursing or feeding. They demand water as such just as much or more than do adults. Assimilation and elimination are more rapid in the child, owing to the more rapid circulation and cell activity. Every baby should be trained to take water from a nursing-bottle until it is three or four months old, after which time it can drink from a cup. In miscarriages and abortions I find that the H-M-C (Abbott) to give all the anesthesia necessary. I have not noted any untoward results from it. My experience with this remedy in labor at full term has been limited, but I do not think it would produce a cyanotic baby unless used in the latter end of the labor. The last case I had no anesthetic or any other drug was employed, yet the well-developed looking baby that it was remained blue for a day or so. So we have no accurate means of knowing whether a remedy is calculated to produce harm to the baby or not, and should not therefore be hasty in our conclusions in this particular. Peoria Heights, Ill. THE ILEAL ARTERY BY BYRON ROBINSON, B. S., M. D. Professor of Gynecology and Diseases of the Adominal Viscera in the Chicago College of Medicine and Surgery in affiliation with Valparaiso University. Arteria Ilei. I introduce the term ileal artery as a rational nomenclature and for the purpose of designating accurate, definitive segments of the proximal mesenteric artery. The ileal artery extends from the distal end of the jejunal artery or from the bifurcation of the jejunal artery to the distal inosculation with its opposite fellow, the ileocolic artery. The ileal artery forms the left circumference, and the ileocolic artery the right circumference of the "ileocolic circle." The mark of division between the jejunal artery and ileal artery is the emerging ileocolic artery. Anatomically the ileal artery serves as the trunk for the emission of some fifteen branches (rami ilei) to supply some fourteen feet of ileum. The functionation of the ileal artery is produced by stimulation of the automatic, specialized peripheral ganglia (Auerbach's and Bilroth-Meissner's), which dilate its peripheral vessels engorging the fourteen feet of ileum. The ileal artery courses distalward between the mesenteric blades to the ileocolic region, inosculating with the ileocolic artery. The dimensions are considerably less than the jejunal artery. It averages four inches in length, and at its proximal end is one-quarter inch in diameter. Clinically the ileal artery is of significant importance on account of the prevalence of tuberculosis and typhoid ulceration in the distal ileum, or on the periphery of the ileal artery. The ileal artery emits some fifteen branches (rami ilei) to nourish the fourteen feet of ileum of such limited caliber (as compared with those of the jejunal artery), with consequent limited blood volume is not only the chief digestive segment of the tractus intestinalis, but is rarely subject to disease (ulceration or perforation). The ileal artery is significant from the fact that it forms the left boundary of the "ileocolic circle." The stimulation of the automatic specialized, peripheral ganglia of which (Auerbach's and Bilroth-Meissner's) controls the caliber of the arteries composing the "ileocolic circle" and hence the blood volume of the ileum. |