be made and from all of them we learn that syphilis is not transmissible by the father in the tertiary stage, or after about the fourth year, but no distinction is made between the stages as to the limit of the mother's power to transmit the disease. Why, then, can we not say that just as long as the father is suffering with the acknowledged infective stages, the child may get it because he first gives it to its mother, and the mother passes it down to her offspring? But if the father has passed the stages of infection before he gets married, or before copulation is engaged in, the children are healthy because his power to communicate the disease to his wife has gone.

White, in Pepper's System, says: "It appears to be highly probable that no woman ever bears a syphilitic child and remains herself absolutely free from the disease," and "the mothers who have thus acquired an immunity have first done so by acquiring the disease."

Mothers, then, must have the disease in a mild form; just as varioloid is a modified form of variola, made mild by inoculation and not by infection. What modern Jenner will rise up above others and offer to a syphilitic race a means, by inoculation, of modifying the course of the disease so as to make it practically nothing as compared to its ordinary course; so that he who has the base desire can prowl about, boastful of his immunity from the fire of brothels. Then he will call upon his doctor for syphilitic inoculation, or vaccination, as a school boy does for vaccination during an epidemic of smallpox.

As to the peculiar notching of strumous children, known as Hutchinson's teeth," it may be observed that they are only found in children that have the strumous diathesis. The two upper incisors are termed the "test teeth." Since Mr. Hutchinson's first paper on the peculiar development of the teeth, Prof. Parrott, Fournier and others have made declarations concurring with him. The conclusion to be drawn is that syphilitic teeth are not always present in children suffering with the inherited form of the disease, but that when they are found it may be taken as sufficient evidence that such children will improve under specific medication.

The only disease that is likely to be mistaken for inherited syphilis is the affection known as scrofula. Lynch, in Pepper's System, says: "In this disease we see the same tendency to increased cell-production, the same tedious, slow and intractable inflammations and ulcerations which are characteristic of scrofula." The similarity has induced many persons to believe that scrofula is nothing else than syphilis in the second or third generation. Quite a number of cases that have presented

themselves with a true strumous history have yielded just as kindly to mercurial inunctions and the iodides as did those cases that were typical cases of syphilis with a typical syphilitic history.

Erichsen says there is no means of positively distinguishing syphilitic lupus from the so-called scrofulous variety. I have under observation a family of eight children, two of whom are dead with, as near as I can learn, 66 summer diarrhea." Within the last few years the younger children have had attacks of the same form of diarrhea. The ordinary remedies made no impression on the disease whatever. The very moment they were given specific treatment they began to improve. This family is what is known as a scrofulous family. No history of syphilis is obtainable.

Again, the similarity existing between scrofula and inherited syphilis will be seen in the report of about twenty cases of purulent conjunctivitis, occurring in private practice during the past four years. These cases were of what is commonly known as "scrofulous sore eyes." It was only possible to obtain a syphilitic history in a portion of the cases, less than one half, and a scrofulous history in the other cases. In the treatment of these cases no distinction was made, they all being placed on constitutional treatment, somewhat after the following for a child two years old:

R. Syr. ferri iodidi,

Syr. sarsap. co.,

Twenty drops every four hours.

aa. ziv. M. Sig.

This was given after taking milk or other food, never on an empty stomach, with hydrarg. cum creta, one grain, three times each day.

The mothers of these children, when suffering with the ordinary complaints, would improve under specific medication almost invariably.

Another point in the treatment is whether the treatment administered to the father, as is frequently done, is a useless procedure or not. If it be impossible for the father to transmit the disease to his offspring per se, then such treatment given with a hope of making an impression on the child, is entirely useless. Sturgis and Diday are advocates of this doctrine.

Without further comment the following cases are respectfuliy submitted:

CASE I. Male, who had passed through the different stages of the disease, was married seven years after receiving the initial lesion. About one year after marriage an apparently healthy girl was born.

In about

one year after the birth of the child its mother was attacked with sciatica of a severe form, which would not yield to the ordinary remedies. Finally she was given iodide of potassium, one ounce in one ounce of water, five drops three times daily after eating, in water, the dose being increased two drops daily. In about one week the pain had almost entirely left. In a few more days it disappeared and has never returned. The medicine, however, was continued for some time. The child, born apparently healthy, had an attack of summer diarrhea that was just as stubborn to the ordinary remedies as the case of its mother. The child was given syrup of the iodide of iron, and the diarrhea was entirely well in a few days.

CASE II. Summer diarrhea, in a child of syphilitic parents, that would not yield to the ordinary drugs, but promptly improved under the treatment just given.

Other cases might be given, but the foregoing are true cases of syphilitic diarrhea that must have specific treatment to be cured. The doctor is frequently consulted by women suffering with headache, constipation, nervousness, sleeplessness, loss of appetite, disturbances of menstruation, premature grayness and decay, neuralgias, looking apparently well, that have been inoculated with the disease in such a way as to have it run the mild or modified course. Such cases can always be improved by antisyphilitic treatment.

The conclusions to be drawn then from this paper are,

First-That a father cannot transmit syphilis to his offspring directly unless the mother of the child has the disease.

Second-That scrofula is an inherited form of syphilis.

Third-Treatment given to the father will have no influence on his

offspring.

Fourth-That there is a mild or modified form of syphilis which always shows itself in mothers of syphilitic children.

THE DURATION OF INFECTIOUSNESS in the acute infectious fever is placed by Dr. Fredrick Pearse (British Medical Journal) as follows: Measles, from the second day, for exactly three weeks; small-pox, fromthe first day, under one month, probably three weeks; scarlet fever, at about the fourth day, for six or seven weeks; mumps, under three weeks; diphtheria, under three weeks.

NOTE ON THE TREATMENT OF THE UMBILICAL CORD.

BY JOHN I. KING, M. D., BURGH HILL, OHIO.

Sometimes we have trouble in securing thick umbilical cords properly. I tie al cords in the following manner: about an ordinary Hamilton's fenestrated artery forceps take three or four turns with a small rubber band, used now so commonly for light parcels, seize the cord with the forceps at the point you wish to apply the ligature, cut the cord about an inch external from this, turn the cut end between the blades of the forceps, roll the band off the forceps and the cord is most securely ligated, as the band will follow all shrinkage. It has advantages over the steel clamp, being neater, less cumbersome, and inexpensive. In dressing the child always turn the cord transversely upon the abdomen, so that the child may not make traction or pressure upon the attachment of the cord in its movements, a frequent cause of discomfiture to the little one when the cord is laid upward along the abdomen.

TYPHOID FROM A SINGLE DOSE.-M. Dujardin-Beaumetz has forwarded to the Paris Academy of Sciences a communication on the Pierrefonds typhoid cases last summer. M. Fernet, who occupies a high post at the Ministry of Public Instruction, his wife and family, hired a house at Pierrefonds, a fashionable resort near Compiegne, contiguous to two others. After they had rented it for the season they were told to beware of the water in the well. On this account they drank exclusively mineral water until the last day, when the stock was out, and the servants were too busy preparing to return to Paris to go to fetch some bottles from the chemist. Madam Fernet said, "For once surely there can be no harm in drinking the well-water." They drank it. Six out of the nine persons have died, including one of the servants. The cook, two of the

four children, and Madame Fernet had had typhoid fever before, and though attacked again by it after their return from Pierrefonds, have got through the illness. The well has been examined and is reported to contain the bacilli which are believed to be associated with typhoid fever. This is a common danger to which visitors to so-called health resorts, both on the continent and at home, are frequently subjected. The facility with which well-water is infected is hidden from the population by the impunity with which filthy well-water may often be drunk by resident families who have become acclimatised. especially when that water is for the moment infected only by non-poisonous fecal matter, and this

fancied immunity often leads to habits of carelessness, for which not themselves only, but their visitors have to suffer.—Brit. Med. Jour.

FAILURE OF THE "BACTERIAL TREATMENT OF CONSUMPTION.At a recent meeting of the Odessa Medical Society, Dr. Filipovitch made a very instructive communication on six cases of advanced pulmonary phthisis, which had been treated by him after the bacterio-therapeutic method, recommended by Professor Arnaldo Cantani. Having obtained, by fractional cultivation, pure cultures of the bacterium termo in meat broth, the author took five cubic centimeters of the bacterial fluid, diluted them with ten cubic centimeters of boiled water (37° C.), aromatised the mixture with one or two drops of tincture of peppermint (to disguise an offensive odor), and made the patient inhale the whole by means of Richardson's spray producer. The inhalations were repeated twice daily. In one of the patients, the experiment was given up at the end of a week, since the man's state commenced to grow worse from the very beginning, and fever, steadily increasing bronchitis, and hemoptysis, had developed. Three other patients died under the treatment, one after fifteen day's inhalations, another after seventeen days, and the third after twenty-five days. The remaining two patients left the hospital after treatment for seventeen and fifty-two days respectively. In none of them was anything like a diminution of the expectoration observed. In one of the fatal cases, shortly before death, the sputum became more profuse, more liquid, and assumed a characteristic bad odor, resembling that of a pure culture of the bacterium termo. At the necropsy, numerous excavations "represented as it were a culture of the bacterium;" the spleen was also enlarged and anemic. In the non fatal cases, nothing like a diminution or disappearance of the tubercle bacilli from the sputum, was detected. In the patient who was treated by the inhalation for more than seven successive weeks, the number of bacilli was distinctly increased during the seventh week. In none of the cases was any influence exerted by this treatment on the temperature, or perspiration, or the body-weight discovered. Finally, Dr. Filipovitch came to the general conclusion that "no good whatever may be expected from the treatment of tuberculosis by the inoculation of the bacterium termo;" while some of his cases seemed to point out that the infection of the human system with the putrefactive-bacteria might prove not nearly as harmless as had been alleged.-Brit. Med. Jour.