Extract from a Letter of Dr. Whitall, Resident Physician of the Colored Home, New York.

607 LEXINGTON AVENUE, 11th Mo. 10, 1867. DEAR DOCTOR,-In accordance with your request I will state briefly my experience in the malignant diseases among the colored women. I have been connected with the Colored Home nearly five years, during which time about two thousand females have been under my immediate observation.

Malignant disease of the uterus I have seen but twice; in each case the woman was over fifty. Endometritis is quite common. Uterine fibroids are exceedingly common, the majority of middle-aged females having them.

My friend and predecessor, Dr. James D. Fitch, who had an experience of twenty-five years among the colored, informed me that he had met with very few cases of malignant disease of the uterus. Very respectfully yours,

SAMUEL WHITALL.

From Dr. J. C. Nott, formerly of Mobile, Alabama.

MY DEAR DOCTOR,-My surgical notes are somewhere nailed up among unpacked books which I brought from the South. I therefore can give you nothing very definite about cancer statistics in races. I have seen scirrhus in the breast and uterus in the full blacks, but much less frequently than in the whites. In the black male it has been most frequently in the medullary form. I cannot now call to mind a case of epithelioma in the black, and I am positive that it is very rare. Even with the whites, epithelioma is most common in the thin-skinned, with reddish hair. After our conversation on this topic I wrote to New Orleans, to Mobile, and to my friend Professor Chisolm, late of Charleston, S. C., now of Baltimore. I send you his letter, which confirms my recollection; and if he had separated the mulattoes from the blacks the difference would have been much wider. The mulattoes are a feeble stock when crossed, not on the Latin races, but on the Anglo-Saxon or the Teutonic race. They are subject to scrofulous diseases, are short-lived, etc. With regard to the keloid facts stated by Chisolm, it is proverbial at the South that keloid is a rare disease among the whites, and the most common of all morbid growths in the negro; they will number, perhaps, as many as all others Very truly yours, J. C. NOTT, New-York.

combined.

From Professor Chisolm, addressed to Dr. Nott.

BALTIMORE, Dec. 6, 1869. MY DEAR DOCTOR,-I am in receipt of your favor, and will gladly put whatever information I have on this or any other subject at your disposal. As regards the relative frequency of cancer in the various races, my experience sustains you, that cancer is not as common in the black race as in the white. I have seen all varieties in both, and I have just looked up some statistics which will sustain our views. In 1859 the State Registrar (of South Carolina) recorded and published the reports of 9,700 deaths: 2,423 among whites; 21 from cancer, 5 males, 16 females. Of 7,277 blacks who died, 29 deaths were from cancer, 5 males and 24 females. The population of the blacks was three times as numerous as the whites, and deaths from cancer only slightly increased. In 1865, in Charleston the mortuary record shows 2,068 of whom 560 were whites, and 1,508 blacks. Among the whites there were 3 deaths from cancer, among the blacks only 2. En passant, as the blacks and whites are nearly equal in population, this shows the relative mortality in the races. In 1866, the deaths in Charleston numbered 1,672: whites, 607, with 7 deaths from cancer; blacks, 1,164 deaths, 4 of cancer. In 1867 there were 1,341: of whites, 462, with 4 from cancer; blacks, 879 deaths, 5 of which were from cancer. In all of these cases the preponderance was greatly among females.

If the ever-recurring keloids be classified, as some do, among the cancers, then to this form the negroes appear peculiarly liable, their skins taking on keloid growth from any cause of irritation, as we have all seen from burns, blisters, incisions, even the cuts of the scarifier in cupping, and boring the ears for ear-rings, etc.

Your friend,

J. JULIAN CHISOLM.

The following extracts are from a letter addressed by Dr. J. G. Gilmore, of Mobile, to Dr. Nott:

"I am satisfied, however, so far as my limited experience enables me to form an opinion upon a subject to which my attention has never before been directed, that you are correct. I never saw any thing like epithelioma in the black race. If, in your large and long experience, you never saw it, it must be very rare. I have seen but one case of encephaloid in the negro since I have been in the city. To make a rough estimate, I should guess that the relative frequency of scirrhus

in the black and white females is about in the proportion of one to six. Cancerous affections of the uterus are far more common in the white than in the black. I have seen, since you left us, more than a dozen cases of carcinoma uteri, and I recollect but one in the negro."

I may add that Dr. J. Marion Sims, from whom I had expected a note on this subject, and whose large experience in the South is well known, informed me that he had seen but two cases of malignant disease of the uterus in the negress.

ON TEMPERATURE DEVIATIONS IN THE DISEASES OF CHILDREN. By Mr. SQUIRE, London. (London Obstetrical Society Trans., 1869.)

THESE observations were presented to the Society much in the order pursued by the inquiry. The first object was to gain by them a more definite idea of the natural history of the states of disease to which children are most liable; next to show their value in diagnosis, especially as an aid to the early detection of the infectious diseases; and, lastly, their bearing on questions of therapeutics and hygiene. Some of the infectious diseases have a long incubative period, and the temperature falls on the throwing out of the rash, or on the local manifestations. This is seen in measles and in mumps. Others have a short incubative period, the temperature afterwards not having the same readiness to fall, as in scarlet fever, where, though the skin is the first tissue to be affected, it is by no means the last. Temperature changes accompanied a definite pre-eruptive period in measles and munps. The incubative period, and the course of the disease, and of chicken-pox and rubeole were traced; a variety of the latter, with scarlet fever-like rash, was clearly distinguishable from scarlet fever by a fall of temperature attending the rash. Influenza and hooping-cough were classed with scarlet fever, and numerous temperature observations of the whole course of these diseases illustrated their analogies. Influenza, like scarlet fever, is suddenly febrile, but the pyrexia has a tendency to subsidence on the third day; when it goes on to broncho-pneumonia, it is somewhat longer; and then there is a sudden fall of temperature when secretion begins. Its passage into diarrhoea, gastric catarrh, quinsy, or herpetic or ulcerated sore-throat, was noticed, and three instances in different families given, where adults had the latter affection, while children suffered from influenza. Hooping-cough is shown to have a preliminary pyrexial period of from five to seven days, most marked in the most insidious cases. This also is true of diph

theria, and forms one of its chief distinctions from scarlet fever. There is a close correspondence between some of the observations in hooping-cough to those made in influenza and croup; but these two diseases, essentially identical, differ from it at first in being suddenly febrile, as well as in the after-consequences. In diagnosis the distinction between typhoid fever and meningitis was illustrated by cases in infants. It is seldom that a single temperature observation could or should be made the basis of a diagnosis; it is not to show what a disease is, but how it affects the patient that the temperatures are taken. Elevation of temperature is indicative of disease of some kind, but the absence of disease cannot be affirmed because the temperature is unaffected. During the rapid growth of childhood sudden rises of temperature occur which do not show danger, but only necessity for care. After these disturbances, not always subsiding at once if there is bad air, bad food, or bad health, sometimes pulmonary or glandular congestions or deposits occur, and are found with a low temperature. The more sudden high temperatures of rapid growth have often been associated with gastric rather than pulmonary congestion. In therapeutics, a novel form of empiricism is to seek remedies to reduce temperature. The subsiding of temperature under certain forms of treatment is perhaps a good proof of the efficacy of treatment in the particular form of disease present. In this way the efficacy of cold to the surface in typhoid, and of quinine in the first week of scarlet fever, is evident. Quinine has at once checked the pyrexia in the early stage of hooping-cough, and has had no effect in its later stages, where a combination of atropine and morphia (one-sixteenth of a grain of each) has been useful. In one case, where, at a still later period, a temperature of 103° persisted, the use of a solution of chloride of ammonium in the form of spray, and fresh air, reduced this high temperature to 99° in two days. Chloral, though often useful in hooping-cough, and of some benefit here, did not reduce temperature, as, by giving sleep, it generally does. While temperature is high, sleep is impossible, and much of the nocturnal delirium and wakefulness of children in some illnesses is owing to this, especially in the first effects of a zymotic poison. This is when quinine is so useful. On the other hand, a marked increase of temperature results, when the eliminating system is followed too closely. Dilute the poison by all means, by pure air espe cially; remove what you can; but to eliminate a poison, if that were possible, instead of eliminating the fluids of the body, the quantity of poison eliminated can only be in proportion to the diseased action present, so that to increase the one you increase

the other. Though children in health have a lower temperature at night than in the day, yet when the depression is great some hygienic effects are inferable. Where the author found as low a temperature as 97° in the night, he also found a low range in the day, and a special connection between this and dislike to or deprivation of fatty food. In a collection of facts every conjecture is an error; yet it is possible that a low or easily depressed temperature may prove a useful guide in correcting the diet tables of work-houses and schools.

CASE OF INFANTILE PARALYSIS. By Dr. CLIFFORD ALLBUTT. (London Lancet, Oct., 1870.)

THERE was nothing in this case which differed from the ordinary history of infantile paralysis. The child was aged eleven months, and had shown every sign of good health and growth until the occurrence of the palsy. It was put to bed one night some months ago, in its usual health, and in the morning was found palsied, almost completely, in both legs. Since that time but little recovery had been noticed, and the legs had begun to waste. Dr. Allbutt, after pointing out the frequency and the peculiarity of this affection of early life, said that great doubts rested upon the pathology of it. The favorite opinion was that the palsy depended upon some reflex irritation; but he was quite unable to see any proof of this hypothesis. He thought it failed in the first requirement of an hypothesisnamely, that it should explain the facts. In the suddenness of the onset, in the absence of previous evidence of local irritations, in the permanence and constancy of the palsy, he saw facts which were rather to be explained upon the supposition of of some sudden lesion of continuity in the centres. In default of autopsies, he was himself disposed to urge the hypothesis that the palsy was due to hemorrhage into the cord. He thought, so far as explaining power went, hemorrhage was a far more probable supposition than the shadowy notion of reflex irritation. Dr. Allbutt then went on to relate a case in which he had actually found hemorrhage in the cord of a young child. The child was aged about six months, and healthy. One day its mother lifted it up a little sharply, and was frightened to see its head fall rather heavily forward. At the time, no ill effects were noticed. But some minutes after, the mother found to her horror that the child was paraplegic of both arms and legs. The paralysis, in its sudden painless mode of onset, very much resembled "infantile paralysis," although no doubt in this case the falling forward of the head