death. The fatal case was one in which operation was necessarily done in presence of grave shock. Two of the cases were for tuberculous disease of the hip-joint, and in both instances blocking the nerves with cocaine was resorted to, and, as a result, neither patient suffered from shock.

EHRLICH'S REMARKABLE STUDIES OF CANCER IN MICE.The inoculation of mice with cancer is being practiced on a very large scale by Prof. Ehrlich, of the Frankfurt Institute for Experimental Therapeutics.

The principal forms of malignant tumor are carcinoma, or true cancer, and sarcoma. Carcinoma occurs only in epithelium, the most important constituent of the glands and the outer layers of the skin; sarcoma only in connective tissue, which is found throughout the body. In man, mixed tumors (part sarcoma and part carcinoma) are very rare, and in mice they have never been known to occur spontaneously. But at Frankfurt a carcinoma that had remained true to type through nine inoculations, began to develop. The microscopical structure of sarcoma in the tenth mouse inoculated, became converted into a pure sarcoma in the fourteenth, and so remained during fifty subsequent inoculations. In another case a like change occurred suddenly, the characteristics of a mixed tumor appearing only in a single generation, the sixty-eighth. In a third case the mixed type seems to be per

manent.

According to current theories carcinoma cells cannot change directly into sarcoma cells. The most plausible explanation of the transformation is that chemical changes in the carcinoma cells cause, through irritation, sarcomatous degeneration in the connective tissue and that the original carcinoma is crowded out by the more rapidly growing sarcoma.

Tissues and cells, whether normal or morbid, can be transplanted with success only from one animal to another of the same species or a species which forms hybrids therewith. Mouse cancer, for example, can be transmitted, permanently, to mice only. Nevertheless, if a rat is inoculated with very virulent cancer from a mouse, a tumor is produced which attains large size in a week,

then diminishes, and usually vanishes entirely within three weeks after inoculation. Inoculations made from this tumor at the time of its greatest development have no effect on other rats but develop cancer in mice.

These facts cannot be explained by the assumption of a natural or "passive" immunity due to the pre-existence of antitoxins in the rat's body, for such antitoxins would destroy the germs of mouse cancer on their introduction and the temporary swelling would not occur. An "active" immunity is certainly produced by the formation of antitoxins after, and because of, the inoculation, for a second inoculation fails to cause even temporary swelling. But this hardly suffices to account for the absorption and disappearance of the tumor, in view of the fact that the latter retains sufficient virulence to infect mice inoculated with it.

Ehrlich therefore has been led to the conception of "atreptic" immunity, or immunity due to starvation of the cancer cells. He assumes that the cell of mouse cancer requires for its growth, in addition to the general nutriment which is furnished in abundance by the rat as well as the mouse, a special nutriment which is found only in mice. The small quantity of this substance which is transferred to the rat, together with the cancer cells, in the act of inoculation maintains the growth and multiplication of those cells for a short time, but when the nutriment thus introduced has been consumed, the growth of the tumor necessarily ceases. After this moment, therefore, inoculation of a second rat with cells from this tumor can have only a negative result, because more of the special nutriment remains to be transferred with the cells, but a similar inoculation produces a rapid cancerous growth in the mouse, the body of which contains the special nutriment in abundance.

This theory also explains the often observed fact, that in a mouse in which a large tumor has been produced by inoculation a second tumor cannot be produced by inoculation from the first For, as the first tumor has grown rapidly and is well provided with blood vessels, it has so nearly exhausted the supply

one.

of the specific nutriment contained in the blood of the animal that the second inoculation falls, so to speak, upon barren soil.

Ehrlich explains the growth of tumors, according to the modern cell theory, by assuming that the morbid cells surpass the normal cells in the power to seize and appropriate food. Now comparatively few of the tumors which occur spontaneously in mice are transmissible to other mice by inoculation. The cells of most varieties of tumors, therefore, have no such advantage over the ordinary cells, and the spontaneous occurrence of a nontransmissible tumor is due, not to an increase in the assimilating power of the cells of which it is composed, but to a diminution in the assimilating power of the ordinary cells, that is to say, to the general debility of that individual mouse. This view is in perfect accordance with the facts learned by experience, that human cancer is most prevalent in advanced age, when the entire organism is debilitated, and that hereditary and constitutional peculiarities are also important factors in its causation.

The tumors of mice show great differences in virulence, as appears from the ease, difficulty, or impossibility of transmitting them by inoculation. Most spontaneous cases of carcinoma in mice cannot be transmitted at all, but the most virulent cases often give one hundred per cent. of successful inoculations. Ehrlich has proved, however, that inoculation from an ordinary, non-transmissible tumor, though it does not reproduce that tumor, has the remarkable effect of making the inoculated mouse immune in subsequent inoculation with tumors of the most virulent type. This result makes it possible to make any mouse immune to carcinoma by repeated inoculations with non-virulent growths and it has been proved that this immunity is not specific, but includes every variety of malignant tumor of either epithelial or connective tissue that has been propagated at the Frankfurt Institute. It would, of course, be premature to draw from these very interesting discoveries the inference that an effective cure for human cancer is within reach, but these results indicate that the experimental investigation is tending in a direction which provides a more hopeful view of the solution of the cancer problem than has been afforded by all previous study of the subject.- Scientific American.

THE NECESSITY OF IRON TO THE PREGNANT WOMAN.- It is universally conceded that the administration of iron in pregnancy is now made expedient by the development of an anemia which is usually foreign to non-pregnant subjects, and which, at one time, was an uncommon occurrence even in the case of the childbearing.

During pregnancy, the appetite is invariably immoderately ca pricious and there is a disposition to gratify the palate by partaking of those foodstuffs which have been rendered fictitiously attractive to the partial, or by the complete, exclusion of the more simple and nutritious viands. While such indulgences must inevitably contribute to the development of anemia. it was not until the modern table supply, consisting almost wholly of such victuals as hot breads, highly spiced refrigerated meats, artificially colored canned goods and pastries, was made the rule with the masses as well as the classes, that anemia of pregnancy became the rule and not the exception.

In addition to the inadequate food supply which is now current, the anemia of pregnancy is rendered more widespread by the style of dress imposed by society upon women in all the walks of life. Furthermore, the blood depletion of prospective mothers of the present day is materially increased through their abandonment of outdoor exercise on account of a false sense of modesty.

In view of the fact that the health of a woman in the pregnant state, and the proper development of her unborn, is always directly dependent on a blood stream that is qualitatively and quantitatively sufficient for the exigencies of pregnancy, the administration of iron is made distinctly needful by the artificialities inseparably associated with modern life.

In selecting the form of iron to be administered to pregnant women, the utmost discrimination should be exercised. That form of the drug which is most easily assimilated and proves most acceptable to the palate is the one which should be employed. This injunction is made for the reason that the nausea which is incident to the pregnant state must not be increased, and for the further reason that constipation must not be induced by the drug. Again, the nutritive processes must be held at the proper standard,

and this cannot be done in the absence of a painstaking selection of the iron to be administered.

cases.

Pepto-Mangan (Gude) is the ideal form of iron for these This contention has the support of logic. The hemoglobin-imparting properties and the nutritive potency of the preparation are confessedly greater than those of any other form of iron. Then, too, Pepto-Mangan (Gude) is more readily absorbed and more completely assimilated than any other preparation of iron. Still further, Pepto-Mangan (Gude) produces no untoward effect upon the mucous surfaces of the alimentary tract, nor does it encourage constipation or increase nausea.

In addition to overcoming the anemia and the deficiencies of nutrition, Pepto-Mangan (Gude) adds tone to the blood vessels and reduces to a minimum the softening of the heart walls which always attends the pregnant state.

Certainly one of the most gratifying effects of Pepto-Mangan (Gude) is the increase of physical strength and buoyancy of spirits which the prospective mother derives from its administration. That the unborn participate in the benefits derivable from Pepto-Mangan (Gude), there can be no doubt, for at birth they present unmistakable evidences of physical robustness, and seem well fortified against those illnesses which are peculiar to infanthood. It is also a matter of common observation that the roborant action of Pepto-Mangan (Gude) enables the mother better to bear the strain of parturition.

It is a peculiar fact that post-operative prolapse through the epigastric wound occurs frequently in operations for malignant disease of the stomach. Such wound therefore should be closed with more than usual firmness and all possible precautions should be taken to guard against post-operative vomiting.-American Journal of Surgery.

CHLOROFORM As a Cure for WHOOPING-COUGH.- Whoopingcough, that dread disease of childhood, which has persistently refused to give way to the many therapeutic measures proposed for its alleviation, seems from the accidental discovery of a Paris