croup are, to all intents and purposes, identical; but it is held that the disease diphtheria is only one of several causes that may lead to croupous inflammation, be it in pharynx or larynx ; in the mouth or rectum; in the pericardial cavity, or the cavity of the bladder; on the surfaces of the conjunctiva, the nasal mucous membranes,' the uterus, or the vagina; and this ground shall be defended, if need be, by authority, by post mortem reports, and by the history of bedside experiences.

Amongst the dangers of the parturient, that of septic infection has of late attracted perhaps the greatest attention.

The source of infection being doubtless in the genital canal, it is natural to suppose that the use of local antiseptic washes will do away with the cause of infection, and so irrigation of the vagina and uterus, either one or both, is practised, and, in a great majority of the cases, without an optical examination of the parts.

Now, it will occasionally happen that such irrigation is not followed by the prompt decline of symptoms expected. Then it may occur to the obstetrician that there exists a cause of trouble in some hidden corner of the uterus, and he irrigates the cavity of that organ vigorously and well. If, after this, there is no subsidence of fever and the other symptoms of infection, the obstetrician stands puzzled. Every member of this society, under similar circumstances, would avail himself of the benefit of a specular examination of the vagina, and, if no cause of sepsis was there discovered, would explore the uterus by the best instrumental means.

In a proportion of cases, the vagina, or the cervix uteri, would be found to be the seat of a croupous inflammation, the pseudomembrane of which affording an excellent entrenchment for microorganisms, its fibrous structure opposing successfully the attack of the phenol or mercuric solution, becomes an undoubted source of septic infection, and the cause of all the trouble.

While believing that well-versed physicians would examine the vagina and discover such a croupous inflammation, it is not I Potter, F. H., Membranous Rhinitis. Jour. Laryngology, Mar., 1889, p. 89.

so certain that they would call it by its right name. Is it not true that most men would pronounce it a diphtheritic infection? Now, admittedly, this may be diphtheria, but, as a rule, it is a croupous inflammation of other origin. It is a focus of infection; it requires antiseptic and destructive treatment lest it lead to fatal septicemia; but in the progress of that septicemia there would not ordinarily be found the symptoms of diphtheria, nor would there be the danger of contagion which always belongs to that disease. The infant may be allowed to nurse the mother, in such cases, without fear of further disturbance than that which would naturally follow from nursing a woman suffering from general septicemia. The infant would not suffer from pseudomembranous laryngitis, nor from diphtheria. And in the case of the affected mother, frequent viewing of the parts discloses that the changes occurring in the progress of the croupous inflammation, while showing a pseudo-membrane identical to that of diphtheria, are not so prone to extend to contiguous parts, not so intractible to local treatment, as the croupous inflammation of true diphtheria.

The object of this paper is to point out the not infrequent occurrence of such inflammations in the parturient genitalia; to state the true nature of this inflammation; to express a belief as to the dangers to the nursing child; and to offer an explanation why some cases of septic infection are not cured by the simple irrigation of the vagina and uterus with antiseptic washes.

278 FRANKLIN STREET.

THE combination of medical journals has evidently been recognized as a wise movement. The Medical Press of Western New York and the BUFFALO MEDICAL AND SURGICAL JOURNAL have pooled their issues, and will hereafter appear under the latter name. Both have been publications of sterling merit, and it cannot be doubted that the result of the combination will be a better journal than either.-Times and Register.

Original Lectures.

PTOMAINES.

BY JOHN A. MILLER, M. A., Pн. D.,

Professor of Medical Chemistry and Toxicology at the Medical Department of Niagara University. Synopsis of a lecture delivered March 21st.

PTOMAINES are chemical compounds, of a basic character, formed during the putrefaction of organic matter. The name, which was given to these compounds by the Italian chemist, Selmi, is derived from the Greek word "ptoma," meaning cadaver, to which the syllable "ine" has been added as an index to their chemical character.

In mineral chemistry, we recognize such substances as soda, potassa, and ammonia as bases. They are compounds which having alkaline solutions give the power of changing red litmus paper to blue. They possess, however, another property which characterizes them as bases, i. e., the power to form salts with acids.

Organic chemistry presents the largest variety of bases, a large number of which contain nitrogen, and it is to a class of these compounds, called "amines," that I specially wish to call your attention.

You remember that marsh-gas has the formula CH1, also that we are able to replace one or all of the hydrogen atoms by any of the halogens, as chlorine, bromine, etc. If, now, we treat methyl chloride (CH, Cl.) with alcoholic ammonia, we obtain the hydrochloric acid salt of a base called methylamine (CH, NH, H Cl). We can replace still another atom of hydrogen, introducing another amidogen (NH,) group, and obtain a compound called methyldiamine [CH, (NH),]. These compounds give us a clew to the chemical character of the ptomaines, i. e., they are bases, but such as contain nitrogen as an essential part of their basic character.

The ptomaines are obtained from putrefying organic substances by various methods, dependent upon their solubility in various mediums. The character of the ptomaine isolated will depend upon the degree of putrefaction, upon the fact whether

during decay there has been a limited or unlimited supply of oxygen, and upon the character of the bacteria at work. We naturally expect to find each variety of bacteria producing its own particular ptomaine. This does not seem an unreasonable belief, as the ptomaines are merely "transition products through which matter passes while being transformed, by the activity of bacterial life, from the organic to the inorganic state;" the very complex molecule being broken up into less complex ones, and so the process of chemical subdivision going on until the simple final products, carbonic acid, ammonia, and water result.

Recognizing, then, that microorganisms are the cause whereby an abnormal condition called disease may be produced in the system, the question naturally arises:

How do these organisms act so as to produce this particular abnormal condition called disease?

The contagious nature of apoplectiform anthrax was first demonstrated by Gerlach in 1845. Four years later, Pollender discovered numerous rod-like microorganisms in the blood of animals afflicted with this disease. Bollinger believed that these organisms caused a deoxidation of the blood, which was the producing cause of the symptoms and death. Virchow, however, reported a number of cases in which the blood of animals that had died from anthrax contained no bacilli, or contained them only in very limited numbers. Joffroy, on the other hand, inoculated healthy animals and found that they died from the effects of this disease before any bacilli appeared in the blood. Bollinger's theory was not entirely abandoned, however, until Nencki proved by a series of experiments that the physiological oxidation was in no way diminished, and consequently there could be no deoxidation of the blood.

Numerous theories were then offered to explain the action of bacteria in producing disease, but they all soon passed away into the history of theories.

The theory which is accepted to-day is, that the bacteria produce a chemical poison by splitting up pre-existing complex

organic compounds in the body. These poisons are the ptomaines, and from pure cultures of bacillus anthracis Hoffa has succeeded in isolating a particular ptomaine which, when injected subcutaneously, produced the symptoms of the disease followed by death.

Prof. Brieger, of Berlin, has succeeded in isolating from slightly impure cultures of the tetanus microbe four poisonous substances, tetanine, tetanotoxine, spasmotoxine, and a fourth unnamed. From the amputated arm of a tetanus patient Brieger isolated tetanine, which was identical in its physiological action and chemical reactions with that obtained from cultures of the tetanus microbe. This compound, tetanine, when injected into animals, produces the characteristic, though not all the symptoms, of tetanus. The remaining three produce paralysis and convulsions.

From pure cultures of coma bacillus Brieger isolated several ptomaines, two of which he considers to be the specific product of coma bacillus. The first one appears to be trimethylenediamine (C, H, N,). Judging from its physiological action, it appears to be identical with a certain basic compound which has been isolated from choleraic bodies. "It causes violent convulsions and tremor of the muscles." The second is unnamed, and its chemical composition unknown. When injected subcutaneously, it produced a paralysis-like, lethargic condition. Respiration and the heart's action became slower, the temperature was lowered, and death resulted in from twelve to twenty-four hours. In some cases, bloody stools were passed. It is to be hoped that further investigation will clear up many dark points in regard to these compounds.

Typhotoxine is the ptomaine which Brieger isolated from cultures of typhoid bacillus. He considers it to be the specific poison of typhoid fever, but as it causes no increase of temperature, it is very probable that future investigation will prove that more than one ptomaine is elaborated within the system. The investigations of Vaughan, Novy, Sirotinin and others seem to point to this belief; though they have not yet succeeded in