chiefly act on the splanchnic area, hence in them the aorta suffers more than the peripheral vessels. It is like the effect of suddenly turning a stopcock in a water-pipe connected with the main supply it is the larger pipes which get the chief stress.

In assuming the erect posture from the horizontal there is not only a rise in the arterial pressure below the heart level but a fall in the arteries above, and to prevent the blood from the upper part of the body gravitating into the capacious vessels of the abdomen, the regulative vasomotor mechanism contracts the splanchnic area, and so raises the mean arterial pressure, thus syncope is obviated. There are many cases, such as Addison's disease, where there is defective action of the vasomotor nerves, perhaps from lack of their usual stimulus adrenalin the splanchnic vessels do not contract, and the patient cannot maintain the erect posture. In the so-called cardio-splanchnic paresis of Albert Abrams, and in cases of orthostatic albuminuria, there is a defective action in the splanchnic area, but the vessels of the skin and muscles contract and make a feeble attempt to compensate for the want of tone in the abdominal vessels. In these cases the systolic pressure is low, but there is an even greater fall in the diastolic pressure.

THE HEART.

No survey of the circulation would be complete without a reference to the self-regulating pump. The heart is composed of two physiologically distinct organs the right and left heart. Each has got its own varying amount of work to perform, and it, under normal circumstances, performs it without any assistance from the other, but in cases of stress or difficulty they mutually assist each other. They act together, and are set to the same time, but this does not prevent one side from beginning or ending contraction before the other, and so much so is this the caseand they are at least to this extent independent — that doubling of both sounds of the heart is one of the most common of cardiac phenomena. In a healthy heart, both sounds are usually doubled every deep respiration.

Ladies and gentlemen, I have said enough to show you the necessity of a well-balanced circulation for the maintainance of

life and health.

It is only with healthy blood vessels that any one can hope to retain his mental and bodily vigor, and expect to attain a green old age.

Obituary.

DR. HUNTER POPE COOPER of the Elkin-Cooper Sanitorium, one of the most noted surgeons of the South, a native of Atlanta, and among its most prominent citizens, died on the morning of August 21, ult., at a little before six o'clock at his home on Peachtree St., Atlanta, Ga., after two weeks' illness with meningitis caused by ptomaine poison.

Dr. Cooper was taken sick on Thursday, August 2, ult., as the result of eating a dish of lamb chops. For the first day his condition was not serious, but on the Friday following ptomaine poisoning set in and he became desperately ill. A few days later the physician discovered symptoms of meningitis, and it soon became apparent that he was stricken with the dread disease. Once or twice since then he rallied, but was never considered out of danger. He died quietly on the morning of August 21, at 5:55 o'clock.

Surviving Dr. Cooper are his wife, who was Miss Henrietta Tucker, daughter of Dr. H. H. Tucker; his daughter, Miss Mary P. Cooper; a son Thos. L. Cooper, Jr.; his mother, Mrs. Mary P. Cooper; one sister, Mrs. Mary Sanders; one brother, Thos. L. Cooper.

Hunter Pope Cooper, son of Colonel Thomas L. Cooper, was born in Atlanta, May 16, 1860, and spent his boyhood there. He received his preparatory education at Neel and Norman's Academy in Kirkwood, and from there entered the University of Georgia, while still very young. Before he was out of his teens he entered the University of Virginia and completed his academic education. Taking up his medical education at Columbia University, he soon attained a high stand. After several years of professional studies there he went abroad and studied in various

medical universities in Vienna and other cities of Europe.

Dr. Cooper was Division Surgeon of the Nashville, Chattanooga, & St. Louis Ry., at the time of his death.

RICHARD COLEMAN CARLISLE, M. D. New York University, New York City, 1862; assistant surgeon in the Confederate service and assigned to duty at Chimborazo Hospital, Richmond, and later surgeon of the Seventh South Carolina Infantry: a prominent citizen of Newberry County, S. C., died at his home nine miles north of Newberry, August 21, from acute gastritis, after an illness of one week, aged 70.

DR. JAS. W. DUPREE died at his residence in Baton Rouge, La., May 26, 1906. He entered the Confederate Service as Assistant Surgeon in 1861, was promoted to surgeon, and at the close of the war, surrendered and was paroled at Macon, Ga.

Editorial.

THE OPSONIC INDEX AND OPSONINS.

AMONG the latest developments and investigations along the lines of "Serum Therapy," by some of the most progressive workers of the day. is a newly discovered series or class of anti-bodies, which have received the designation of Opsonins from the Latin obsono, to cater for, to prepare for eating, etc. These opsonins, as other anti-bodies, occur in normal serum and are produced anew by immunization with certain suitable foreign cellular molecules or receptors, and possibly may give us curative or antilytic results. They may be considered as the products of the reactions of cells in the body to certain molecules in bacteria, red corpuscles and possibly other cells for which they have a special affinity.

Many diseases are conveyed through the medium of the blood, which, grossly, consists of plasma, with red and white corpuscles. The red corpuscles are carriers of oxygen, taking an active part in metabolic processes; while the white corpuscles are largely active in defending the blood against the action of disease germs, by attacking and devouring those intrusive and harmful microbes that obtain access to the vital fluids and tissues. (Phagocytes, phagocytosis.) They engulf these bacteria, as

the ameba does its food, and having taken them in unto themselves, carry them to the liver, spleen, etc., there to be finally gotten rid of. In microscopic examinations the white corpuscles have been found with the microbes inside of them.

Dr. Joseph Hume of Edinboro, says: "This theory with regard to the functions of the white corpuscles seemed to be very complete, but it is now maintained that it has been upset, and is erroneous. It is said to have been demonstrated that there is something in the serum of the blood, called opsonins, that does battle with the bacilli, and that the white corpuscles are merely scavengers which carry off the bacilli after they have been worsted by the opsonins. Hence the conclusion that in fighting disease-consumption, for instance - we must not aim to increase the number of the leucocytes, but to strengthen the opsonins."

According to Hektoen, opsonins like agglutinins and precipitins may be conceived to possess two molecular groups, a haphtophore, (haphtein to cling to), whereby "they attach themselves to corresponding receptors in bacteria and other cells, and a functional group which may be called the opsoniferous, whereby is effected in the cell to which they are attached some change, physical or chemical, that is necessary for phagocytosis. Whether it is possible to destroy or inactivate the opsoniferous group and thus to change an opsonin into an inactive opsonoid, comparable to the oid' modifications of other antibodies, remains to be seen."

He further says: "We may regard a leucocyte as a drop of viscid fluid, largely colloid in nature, suspended in a medium in which it is nearly or quite insoluble. Within the drop the particles are subject to the same pressure from all sides, but at the surface the pressure is unequal because of the difference in the cohesion pressures of the two fluids, and as the result of the surface tension a delicate permeable membrane is formed.

The tangible reactions of motile cells like leucocytes to various stimuli are generally interpreted as results of changes of surface tension. When the surface tension is lessened at any part of a leucocyte the wall at this point bulges, and as the contents of the cell flow in here the whole cell moves toward the point of lessened tension. On the other hand, increase of tension at any one point causes bulging elsewhere and the result is that the whole cell tends to move away from the point of increased tension.

Now the stimuli that may cause these changes may come from within the cell and be the result of metabolic activities and chemical or physical in nature. They may give rise to spontaneous motion. Or stimuli may come from without and be chemical, electrical, thermal, or mechanical in character. At present the external forces concerned in the motion of leucocytes are regarded as essentially chemical in nature and we speak of the manifestations of these forces as chemotaxis, the term applied

by Pfeiffer in 1888 to the attraction that the malic acid in the female sperm cell exercises on the spermatozoids of certain ferns.

Phagocytosis is essentially ameboid motion, continuing until the object is enclosed within the phagocyte, or, in the case of large objects, partly so enclosed. Viewed in the light of the foregoing considerations, the action of opsonins may be defined in all brevity to consist in so changing bacteria and other cells that these by chemical or electrical (possibly also mechanical) means diminish the surface tension of leucocytes and thus bring about phagocytosis or, as stated in terms more familiar, substitute positive for negative chemotaxis."

According to Hume, "The Opsonic Index' shows by figures the resisting power of an individual as against bacilli. Suppose, for example, that in a healthy subject each white corpuscle is found to englobe eight bacilli; in another patient, who is consumptive, the number entrapped falls to four, and in a third to two; their opsonic indices would be, respectively eight being the normal 1, .5, and 0.25. It is urged and maintained that in proportion to the power of resisting disease is the chance of recovery. The colorless corpuscles ought to eat up or appropriate the bacilli, but they are not always hungry, and they are sometimes satiated."

The inference or conclusion, which, however, may as yet only be postulated, is, to stimulate the appetite of the leucocytes, by giving them a vaccine, which when injected into the blood causes the development therein of a substance or molecules, which entering into chemical combination with the bacilli, microbes or germs, renders them not only digestible but appetizing to the phagocytes, this substance having been given the newly coined term or designation of Opsonins.

A. E. Wright, M. D., formerly Professor of Physiology at Netly, and now of St. Mary's Hospital, London, and who has been recently knighted. has been quite active in his work as to Opsonins, (see London Lancet, December 2, ult.), also may be mentioned Dr. R. H. Urwick, British Med Jour. July, 22, 1906; L. Hektoen, M. D., of Chicago, Jour. A. M. A., May 12, 1906; and Dr. Norman Ditman of New York gave a very able review of the subject, which was followed by a discussion of Technic and Clinical Results by Dr. Ernest Bradley, also of New York. at the last meeting of the American Medical Association, in the Section on Practice.

So far as we have been able to gather, as much as may be hoped for, has been briefly summarized as follows by Hektoen:—

"Normal serum may possess lytic power, but not opsonic, and vice versa."

"Immunization may give rise to opsonic substances, but not to lytic or agglutinizating."