valerianate, digitalis powder, Dover powder and squills, aa 5 centigrammes with theobromine 50 centigrammes; emetine hydrochlorate, codeine bromide (ampoules of 2 to 4 centigrammes), belladonna, etc.

The Allen Treatment of Diabetes Mellitus.Williams (American Journal of the Medical Science, June, 1921), presents a study of 100 patients who had reducing substance in the urine from which he concludes as follows: (1) Statistics as to the prevalence of diabetes, cures obtained and other data, based on former and inaccurate and incomplete methods of study, are untrustworthy. It is quite impossible therefore to compare with fairness results obtained by the use of the Allen method and results obtained by methods formerly in use. (2) In spite of these difficulties, an extended clinical experience covering the use of all known forms of diabetes treatment justifies the conclusion that the Allen treatment is a distinct clinical advance. While permanent clinical cures are not attained, nevertheless patients for a considerable time are much benefited. (3) It is difficult to say how much is added to the expectancy of life of the diabetic by this treatment. young people in whom the disease is most serious, it would appear that it is at least doubled. Middle-aged and elderly diabetics who are not too seriously afflicted with complications and when faithful to the treatment can probably survive the life expectancy of the average normal individual. (4) The Allen method is of the greatest service when instituted early in the disease. Most of the failures in its use are due either to serious complicating disease, or more frequently to unfaithfulness on the part of the patient. In the majority of patients, its value is in inverse proportion to the seriousness of the failure of metabolism.

In

Salpingitis. Eason reported in the Medical World (September, 1921) he had found that heavy doses of sodium salicylate in either the acute or chronic forms of salpingitis give the quickest and most lasting effect of anything he has ever used; in fact, he has kept a few cases on this treatment for weeks or months, ridding them of symptoms of salpingitis that had been with them for five or six years. This also quiets the nervousness of these patients, one of the symptoms that is always most markedly present.

Varicose Ulcers.-Laude in a recent issue of the Jour. de méd. et de chir. prat., describes the treatment of varicose ulcers by means of "Vienna cream," a method which permits of the patient following his occupation during treatment. The ulcer and surrounding parts are first carefully cleaned and rendered aseptic by moistening with ether. This is slightly painful at first, but the pain is dispelled by the sensation of cold which follows. The ulcer is then freely covered with Vienna cream, the composition of which is as follows: almond oil 140 gm.; lime water 60 gm.; zinc oxide 60 gm.; borax 40 gm. The borax is dissolved in the lime

water; this is mixed with the almond oil to form a cream, with which the zinc oxide is carefully incorporated. This cream, which will keep for several weeks without becoming rancid, is spread on the ulcer and covered with several layers of gauze and kept in place by a bandage. The dressing may be renewed in five or six days, by which time the discharge will have become apparent on the surface of the bandage. Complete cicatrization, even in extensive ulcers, will take place in from six weeks to three months.

The Use of Pilocarpine and Adrenalin in Bronchial Asthma.-In the Archives of Internal Medicine for February, 1921, Alexander and Paddock state their conclusions in regard to the treatment of bronchial asthma as follows: 1. In a series of twenty cases of bronchial asthma, a general examination with routine laboratory aids and drug tests revealed no constant associated condition.

2. The most frequent finding was abnormally increased sensitiveness to pilocarpine. These cases frequently presented constitutional defects (status lymphaticus) and abnormal reactions described as characteristic of the condition called vagotonia.

3. The majority of cases reacted also to adrenalin with an abnormal rise in blood pressure and other characteristic signs-pallor, tremor, sometimes rigor-denoting increased sensitiveness to this drug.

4. A relation between low blood pressure and excessive adrenalin reaction was apparent, while the smaller number of cases with normal or high blood pressure gave regularly normal reactions.

5. Cases reacting excessively to adrenalin were found to be relieved by 0.25 Cc., a much smaller dose of the drug than is usually employed.

The Medical Treatment of Ulcer of the Stomach and Duodenum by Sippy's Method. In a recent number of La Presse Médicale, Loewy gives in comprehensive detail the rationale of this method, which has been warmly endorsed both by Moynihan and C. Mayo, that whatever may be the first cause of gastric ulcer it is maintained by the combined action of pepsin and free acid on the exposed albuminoids. Sippy therefore aims at maintaining a neutral medium in which the pepsin will have no solvent action. So long as the acidity is controlled in this way, fasting is unnecessary, Gastric cancer must always be excluded before commencing treatment.

The technic consists of (1) rest in bed for 3 weeks; (2) a small meal every hour from 7 a. m. to 7 p. m. The meal is composed of concentrated food-100 grammes of a mixture of equal parts of cream and milk. (3) Midway between the meals, i. e. at 7:30, 8:30, etc., an alkaline mixture is taken with a glass of water. The following mixtures are used alternately:Heavy calcined magnesia Sodium bicarbonate Calcium carbonate

1.

2.

Sodium bicarbonate

āā 50 cgm. 50 cgm. 1 gm. 50

(3) After the last meal the doses of alkaline mixture are continued every half hour until four doses have been taken. Half an hour after thae last done (i. e. 9:30 p. m.), the remainder of the gastric secretion is withdrawn by the stomach tube.

After two days of this strict diet, an egg and a biscuit or a little bread and butter may be taken in addition during the morning, and 100 gm. of cereal in the afternoon. Thereafter the diet is gradually increased. In this way, enough nourishment may be given to produce a gain in weight of 2-3 lb. per week. Samples of gastric juice are taken at least twice in the afternoon and thrice in the evening of each week. If free acid is found, 30 gm. of calcium carbonate are added to the alkaline mixture. Experience has shown that if acidity is controlled at the end of the afternoon it will be controlled at any other time during the day.

By the beginning of the fourth week the patient is able to resume his occupation. He takes three light meals a day-sufficient to maintain weight and at the same time exciting the minimum gastric secretion. After 10 weeks, and again after 16 weeks, the alkaline mixture is withheld for 5 days. Treatment is continued over one year at least.

There may be retention of gastric contents resulting from spasm. In these cases it may be necessary to give every hour:

If more than 100 c. c. of acid secretion be withdrawn at 9:30 p. m. the administration of alkalies must be continued up to 11:30 p. m.

Treatment of hematemesis is based on the same principles-the hemorrhage resulting from digestion of a blood-clot. Only at first alkalies resulting in production of CO, should be avoided and replaced by calcined magnesia.

The results of Sippy's treatment are (1) disappearance of pain; (2) abolition of gastric retention; (3) arrest of hemorrhage; (4) rapid healing of the ulcer.

Danger to Hearing From Water In Ears.So many cases of injury to the ears are being reported as a result of bathing, says Dr. Franklin W. Bock in a recent communication on the subject, that it is important to know just what is the cause of these infections and injuries and what is best to do to prevent and treat them.

Animals which spend part of their time submerged in water are supplied by nature with an automatic device which shuts off the ears when they submerge. Man has no such device and hence must use his own genius to guard himself against injury or infection.

These ear troubles come in three ways:

either from the impact of the water when diving or from the effect of irritants in the water which enters the external ear; a third way being due to the forceful blowing of the nose to clear it of water which may thus be forced thru the Eustachian tubes into the middle ear. The first two of these causes usually result in an inflammation of the ear drum membrane or the lining of the external canal and if treated early clears up with no reduction of hearing; if these cases are not treated, however, they may result in the extension of the inflammation to the middle ear which en results in greater or lesser reduction of hearing and maybe to a long siege of chronic purulent discharge from the ears.

The third of these causes results in injury and consequent inflammation of the middle ear and unless treated early usually results in a marked reduction of hearing.

Of course, the best thing is to prevent the entrance of "water in the ears" is possible. Many people have no trouble, but if one knows that water easily enters the ears it is wise to plug the ear with a small piece of cotton before entering the water; also for persons who are fond of deep diving this is a very wise precaution as it in some measure breaks the impact of the water.

If water does enter the ear, it is usually a very easy thing to get it out if a person will only take it easy and not get excited. Pulling the external ear violently or going thru all sorts of gyrations in an effort to get it out are useless and to be deprecated. These efforts may cause more trouble than the water itself. The best thing to do is to take a small pledget of cotton and twist it into a wick about twice the size of a toota-pick and about an inch and a half long. Push this wick down into the external ear as far as it will go without hurting and leave it there for a moment. It will immediately absorb the water and when you remove the wick the ear is usually clear. second or third application may be made if necessary.

A

If several applications do not relieve the situation it is probably due to the fact that the ear has an accumulation of ear wax in it. When the water enters the ear which has wax in it, it mixes with the wax and makes a kind of mud of it and any manipulation simply pushes this mud deeper into the ear and makes the stuffy feeling worse rather than better. Of course, a case that does not respond to these emergency measures should be sent to an ear specialist at the earliest moment as the longer the water remains in the ear the greater is the danger of irritation and subsequent infection.

Often when splashing around in the water a person will get a mouth full which starts a violent coughing or gagging and one is often tempted to violently blow the nose to clear the water out. This should be done very carefully for there is danger of blowing water mixed with the secretions of the back part of the nose up thru the Eustachian tubes into the middle ear where it too often causes serious trouble.

The early symptoms of trouble from water in the ears is usually a feeling as if the ear

erect an edifice within easy access of the people it is to serve, and it is estimated that the cost of erection and maintenance will be $500,000.

In view of the worthy cause with its many activities of direct value to the public walfare, and in view of the sacrifices physicians are called upon to make in the hospitals and dispensaries and in the private practice, and also in view of the fact that all activities of the institution will be conducted without remuneration, the Bronx Physicians' Club feels that it is justly deserving of the support it asks, and to this end is soliciting funds and material aid. There will be a monster bazaar from October 8 to 15, 1921, at the 2nd Field Artillery Armory, at 166th Street and Franklin Avenue, Bronx.

Bronx center

The Bronx Physicians' Club, Inc. physicians have established a medical that will be unique in many respects. It will be an institution which serves as a common meeting ground for physicians and laymen, where problems relating to medicine of mutual interest and benefit will be given consideration. Thru the establishment of a well-appointed library in connection with an Academy of Medicine, it is hoped to fill a much-needed want, and as outlined will be a department from anything heretofore attempted.

There is no institution which serves the physician in an educational way after his graduation from a medical school, and the only course open to him is a postgraduate school, which after all, is a brief and limited course of instruction and altogether inadequate in keeping the practitioner abreast of current advance. A continuous advancement in the proficiency of the physician is demanded and to meet this need the organizers plan a continuation school for the physician where he may give, as well as receive, instruction. All branches of science allied to medicine and the public health will be considered, the work being in charge of committees consisting of specialists in their lines.

The Academy of Medicine, as planned, in addition to serving the physician as a school of instruction, will also undertake special research work in all problems of benefit to the public health and welfare. For the public, series of lectures will be regularly delivered on topics of child welfare, preventive medicine, public health education, and first aid to the sick and injured. All these lectures will be previously revised and approved by groups of specialists, so that the information will be the combined knowledge of unquestioned authorities.

The membership of this new organization known as the Bronx Physicians' Club comprises the members of the various medical societies and those active in hospitals, dispensaries, and the health department. Moreover, the scientific activities are open to physicians, members or nonmembers. To carry out this enterprise, the Bronx Physicians' Club must

Missouri Valley and Southwest Medical Association to Meet in Kansas City.-The "Southwest" and "Missouri Valley" Medical Associations will hold their joint session in Kansas City, October 25 to 28, 1921. Dr. E. H. Skinner of Kansas City is the "Southwest" president, and Dr. W. O. Bridges of Omaha is president of the "Missouri Valley." A four-day meeting is being planned with clinics in the various hospitals each morning and reading of papers in the afternoons. Five sections will hold sessions, comprising Medicine, Surgery, Obstetrics, Eye and Ear, and Genito-Urinary. Two general sessions will be held, and one evening session, when the orations will be given. Arrangements for clinics are being made by the officers and committees of the "Medical Veterans of the World War," which body will be in session during the week. On Monday, October 24, the "Mid-Western Association of Anesthetists" will be organized and present a program. Dr. Morris H. Clark, Sec'y, Rialto Bldg., Kansas City, Mo.

The Forthcoming Meeting of the American Public Health Association.-The American Public Health Association announces four phases of its semi-centennial celebration to be held in New York City, November 8-18, 1921:

(a) The Scientific Sessions will be held November 14-18. There will be programs of the following sections: Laboratory, Vital Statistics, Public Health Administration, Sanitary Engineering, Industrial Hygiene, Food and Drugs. There will also be special programs on Child Hygiene and Health Education and Publicity.

(b) Health Institute, November 8-12. During the week preceding the convention proper there will be organized demonstrations of the various types of public health activity in New York and environs: Health Department bureaus, laboratories, health centers, clinics, hospitals, etc.

The purpose will be to show health functions in actual operation, especially those which may be duplicated in other cities. In one sense, the Health Institute may be considered as a school of instruction in practical health administration.

(c) Dr. Stephen Smith, the founder and first president of the Association, who is now in his 99th year, will be the guest of honor at a ban

quet to celebrate his approaching centennial and the semi-centennial of the Association.

(d) A Historical Jubilee Volume, "Fifty Years of Public Health," will be published about October 1. There will be articles by seventeen authors, relating to the accomplishments and present status of each of the important branches of public health. While concentrating upon the public health of the last fifty years, the book will describe the earlier beginnings of public health in an introductory way, and may, therefore, be considered a general history of public health from the earliest days to the present.

Detailed announcements, programs, and information concerning special railroad rates will appear in the American Journal of Public Health and the News Letter of the Association from time to time or may be had upon addressing the Association at 370 Seventh Avenue, New York City.

New Head of the Abbott Laboratories.It will be learned with great satisfaction by the many friends of Dr. Alfred S. Burdick that he has been elected to fill the vacancy as President of The Abbott Laboratories, caused by the death of Dr. W. C. Abbott.

He is a graduate of the Alfred University, Alfred, N. Y., and Rush Medical College, Chicago. He has been closely associated with The Abbott Laboratories for over seventeen years, and for the past six years has been Vice-President and Assistant General Manager. Dr. Burdick has been known to physicians generally as the Editor-in-Chief of one of the country's foremost medical journals, the American Journal of Clinical Medicine. His work in this position has received general recognition and his scholarly attainments no less than his administrative talents have won him the admiration of his friends the country over. A big, lovable man of great ability, the Abbott Laboratories are fortunate, indeed, to be able to command the services of Dr. Burdick. Probably there is no other medical man who is so well qualified by experience, training and broad mental capacity to "carry on" the work so ably launched and splendidly conducted by his predecessor. Dr. Burdick may count on the best wishes and hearty support and cooperation of his countless friends.

time to educate the people themselves in all health matters. This proposal has been given the approval of the officials of the American Public Health Association, and the Exposition is, therefore, to be held in Grand Central Palace the week beginning November 14, under the joint auspices of the New York City Department of Health and the American Public Health Association.

Receipts from the sale of floor space will be used to finance the Exposition, but all profits from the sale of tickets will be used for the establishment of nutritional clinics for undernourished children, to help pay the expenses of the semi-centennial meeting of the American Public Health Association or for equally impor tant public health purposes.

This enterprise is so worthy that it should be supported and promoted by every physician in the country. To make a success of the Exposition, it is necessary that those who are engaged in business enterprises having any relation to the health of the people should take floor space and make exhibits in this Exposition.

Mental Defects in School Children.-"The prevention and correction of mental defectiveness," says the U. S. Public Health Service, "is one of the great public health problems of today. Its influence is continually cropping out. For instance, recent studies have shown that feeble mindedness is an important factor in prostitution, and that a marked proportion of juvenile delinquency is traceable to some degree of mental deficiency in the offender:

"A recent state-wide survey in Oregon shows that more than 75,000 men, women and children out of a total population of 783,000 are dependents, delinquents, or feeble minded, and that more than 500 school children out of a total enrolled school population of 32,500 are more or less mentally deficient. The latter fact is significant when it is remembered that the condition of the children of today is the best possible index to the condition of the community of tomorrow.

"The Oregon figures are considerably lower than the average shown by the draft examination, indicating that they are certainly not higher than those that would be obtained in other States."

A Great Public Health Exposition. The annual convention of the American Public Health Association will be held in New York City on November 14. It is expected that 5,000 delegates, consisting for the most part of health officers, of the cities of the United States, Canada, France and England, will attend this convention.

It is proposed by Dr. Copeland, the Health Commissioner of New York City, to hold a Health Exposition to display to these delegates the work being performed in this city to safeguard the health of the people, and at the same

Origin of Fruits.-The strawberry comes from a cross between the native strawberry of Virginia and that of Chile. The raspberry is native in temperate Europe and Asia. The apricot originated in China. The peach was originally a Chinese fruit. The cherry originated around the Caspian Sea. The plum comes from the Causasus and Turkey. The pear is native in temperate Europe and Western Asia. The quince comes from Southeastern Europe, the Causasus and the Caspian region. The apple, one of the oldest fruits, originated in Persia, it is generally believed. The almond comes from Persia. The fig originated in Syria. The grape is native in southern Europe.

Special
Therapeutic Article

TEST OF A NEW TREATMENT FOR

TUBERCULOSIS CONDUCTED

AT RIVERSIDE HOSPITAL.

BY

EUTHIMIOS H. L. TCHOR-BAJ-OGLU, A. B.,
M. D.,

Physician-in-Charge Tuberculosis Division,
New York City.

Upon permission received from the Director of the Bureau of Hospitals, Dr. Robert J. Wilson and the approval of Commissioner Royal S. Copeland, I was authorized by Dr. Thomas F. Joyce, Superintendent of Riverside Hospital to take charge of the experimental research work for the benefit (if any) of the tuberculosis cases of said institution and to determine as well if there was any merit in the preparation known as Nuforal (formo-nucleoallyl) produced by the Nuforal Laboratories, Inc.

As the first important step was to obtain some fundamental knowledge and full particulars concerning the product, its ingredients and the therapeutic and physiologic effects upon pulmonary tuberculosis, an interview was arranged by Dr. Joyce for the writer and Dr. Jacob Oshlag. The latter is Attending Physician and a member of the Board of Managers of the Manhattan State Hospital at Ward's Hospital and had treated a number of his patients with Nuforal. At this interview, some of these cases were interrogated and examined by me and were found to be in far advanced stages of tuberculosis, with extensive signs of fibrosis. However, the absence of a knowledge of their previous condition made it difficult to determine the extent and

nature of the physical improvement. One fact, however, was significant; that the patients spoke highly of the treatment, adding that they noticed marked general improvement; felt much better and expressed an earnest desire to have the injections continued. These phases naturally are to be expected in all cases in which a new remedy for tuberculosis is tried. Therefore, they would not have impressed me, had they not been supplemented by the interesting facts that the marked abatement of objective symptoms was, in a number of second-stage cases, accompanied by several instances of negative sputa. In response to inquiry, I was informed that the ingredients contained in the product are formic acid, nucleinic acid and allyl sulphate; that it was pure chemo-therapy, that while no scientific data were available, a number of tests made by them on both insane and mentally normal cases had shown remarkably good results; and all were without a single injurious effect. The method of administration was by deep subcutaneous injection in the infrascapular space; and that the dosage was 20 or 40 minims q. a. d. Dr. Oshlag showed the writer a number of official cards from New York Department of Health and stated that a substantial number of cases showing positive sputum had, at the expiration of three months, become negative. This information was forwarded to Dr. Wilson by Dr. Joyce, and after consulting with Dr. Boze and Dr. Fischer, then attending physicians on the Tuberculosis Service, a test was decided upon and preparations were made for the treatment with the results appended.

Early in April of this year, Dr. Oshlag and his staff visited Riverside Hospital and all of the tuberculosis patients who were interested in the new treatment were invited to assemble in the hall. They were