we have seen on this subject. Dr. Senn is so well known as an author and as an operator that a paper on the wounds made by Spanish bullets from his pen has a special value. The comments are brief, of necessity, as they were written while the doctor was on active duty.

Colonel Senn notes that the Mauser bullet seldom carries clothing or other infected substances into the tissues. The wounds made were mostly aseptic. Many healed by first intention in a very short time. Infection, when it did occur, usually began superficially at the wound of exit. Dr. Senn explains this by the greater laceration at this point. Many cases of infection were caused by lack of proper medical supplies at the front, and the consequent frequent change of dressing as the patient was passed on to the rear, where the main hospital was located.

The tubular wound made by the bullets was surrounded by a zone of contused tissue, the wound being filled with liquid or coagulated blood. Later, the swelling of the tissue completely occluded the tract of the bullet, a dark discoloration, with parenchymatous extravasation indicating where it had been.

The value of the X-ray was fully demonstrated. Dr. Senn speaks highly of its usefulness in locating bullets in the tissues. The probe is out of date. The X-ray also told whether or no bones were fractured.

By getting the wounds of entrance and exit, the organs and tissues passed through were determined. The bullets traveled in a straight line as a rule, and were very rarely deflected.

Of the cases of gunshot wounds of the head that lived for several days a number were in a fair way to recover. All those that died died from intracranial infection. Cerebral hernia was the first symptom of inflammation. Here follows a number of cases that cannot be detailed. A curious thing that may be noted is the ignorance of the location of the wound at the first shock. The victims report a sudden tremendous shock, but the idea of a gunshot wound does not occur to them. This is true of wounds anywhere.

All bad wounds of the spine injuring the cord either died or are mortally injured.

Wounds of the chest caused surprise by their rapid healing. In

many cases bullets passed entirely through the thorax without causing any permanent pulmonary symptoms. At the writing of Dr. Senn's report, two weeks after the battle of Santiago, many of these chest wounds had healed up. The greatest danger from chest wounds made by small calibre bullets is in injury to the heart or great blood vessels. Empyema was rare.

Dr. Senn says that in many abdominal wounds, where bullets. passed through the intestines, the patients recovered without operation. He contends that this confirms his previous published statements that active interference is not always called for in abdominal gunshot wounds.

Few primary amputations were necessary. A few secondary

ones were done.

Altogether, from this report, it would seem that the wounds of the swift small-calibre bullet were not so fatal as the old-fashioned kind. Had the surgeons at the front been better equipped still better results could have been shown.

I

DANGER IN HASTE.

T is a curious fact, but a fact nevertheless, that persons afraid of

nothing, that they can see, are panic-stricken when disease threatens them. This has been amply demonstrated by the army at Santiago. Men who appeared to have no fear of Spanish bullets, so soon as the fighting was over, were in dread of the climatic diseases. The officers united in protesting against further stay in Cuba and practically compelled the authorities to send them north.

We must again call attention to the danger of too sudden a transition of sick men from a foreign to a home climate. THE NORTH AMERICAN noted this danger in July. Only those fully convalescent, or those not sick, should be sent home. The English army has found this imperative. A recent writer in the "Lancet," Dr. William Forbes-Leslie, of Aberdeen, notes it. In speaking of malaria, he says:

"Another point which is not generally known is that a sea voyage is unfavorable unless the patient is fully convalescent. H. R.

H. Prince Henry of Battenberg died at sea; so did Sir William Maxwell. It is a common thing for men to come on board at Beira incompletely convalescent and die before they reach Natal. In many cases men completely convalescent succumb to the terrible black water fever after being a few hours at sea. What the cause is it is difficult to say. Possibly the motion of the vessel acting through the nerve centres on the vasomotor nerves of the liver may disturb its glycogenic functions, or a chill may be the cause, or it may be in the atmosphere itself. Whatever it may be, it is a law of malaria which it is well to bear in mind when advising a patient to take the voyage to Europe. It is too frequently the voyage from which none return."

This is true of malaria contracted in Africa and in India.

We think the above experience has been that of all tropical writers. It is but a few weeks since a physician returned from India who had had tropical malaria himself. He said that he was moved too soon when ill, and his health had in consequence been broken ever since.

Notes and Comments.

A Pasha of Three Tails.-When an editor thinks he possesses all sapiency and keeps silent, he is a Pasha of Two Tails. But when he not only knows more than the rest of the world, but seals his folly by writing himself down as did poor Dogberry, he is fully entitled to add one to the number and becomes a Pasha of Three Tails. Chicago possesses such a dignitary. We herewith extend our warmest congratulations on his latest honors. Most men strenuously prefer distinction to come to them in quite other ways, but this does not occur to the Pasha of Three Tails. He accepts any title or office, and if he cannot rule would like to ruin. When a man who has been honored by the Institute by an election to its highest office coarsely criticises in his journal the acts of all his successors in that office and attempts publicly to demonstrate how much better he could have done it; when he attacks the leading committees of the Institute and attempts to read out of the society some of its best and most earnest workers; when he sneers at any effort to decently honor the memory of our dead; when he falsely charges ring rule, and insults every member of the Senate of Seniors, we realize that the great and mighty Pasha is nothing after all but an escaped Adullamite. He is a disgruntled and discontented dweller in the famous cave where those of his ilk have long congregated. Chagrined at the defeat of his schemes, he disloyally states the

Institute is "down at the heel" as a result of "ring rule." As a matter of fact the Institute was never more prosperous than now, and he knew it when the misleading statement was made! Turned down by the Interstate committee he clamors for its abolishment; and he seems to hope to introduce dissensions in the councils of the Institute at Atlantic City by setting the West against the East, and the younger against the older members. But the attempt will be in vain. The Atlantic City meeting will be a splendid one; President Bailey will receive united and hearty support, and the "Pasha of Three Tails" will be again reminded by the Institute, "That it is a darn sight better not to know so many things than to know so many things that ain't so!"

The State Society. The semi-annual meeting of the Homœpathic Medical Society of the State of New York will be held at Syracuse Thursday and Friday, September 22 and 23, 1898. The chairmen of the Bureaux have been working energetically and have not only obtained a large number of valuable papers but have arranged for a carefully prepared discussion which will be of great interest. The local physicians will do their utmost to make the hospitality of Syracuse long remembered, and have laid up an extra supply of salt. Reports from different sections of the State indicate a very large attendance and the most successful meeting in many years.

Advice to Specia sts.-In a paper read before the Boston Homœopathic Society ("Am. Med. Monthly," Mar., 1898), Dr. C. Wesselhoeft enters a plea for more study and practice of pure homœopathy by our specialists. He states that many of the medical and surgical procedures used by specialists are copied from the old school and thus show a lack of originality, whereas, a closer study of the materia medica and the homoeopathic application of drugs would produce more beneficial results. Each specialist is prone to trace all aches and pains to disturbance of the special organ that he treats, and acts accordingly, using for the most part old school methods. Dr. Wesselhoeft claims that the general practitioner eventually gets hold of many eye, ear, throat, nervous, and other cases that have been sadly damaged by the so-called specialists by this homœopathic treatment. He calls for specialists in homoeopathic prescribing.

Ambulance Service; Brooklyn Homoeopathic Hospital.-The ambulance service at the Brooklyn Homoeopathic Hospital has been discontinued for lack of further appropriation by the city. This will, to a certain extent, detract from the value of the institution to its house staff. Unquestionably many ambulance calls are unnecessary, but that does not destroy the value of such a service. The ambulance surgeon, when he starts out from his hospital, is as nearly autocrat as he ever can be. He must rely solely on his own judgment until he returns once more to his institution. On starting out he knows absolutely nothing about the case he is to see. It may be a common drunk, it may be a case of sudden illness, it may be one

of serious accident, it may be a maternity case. On reaching his patient the ambulance surgeon must make his diagnosis, make up his mind promptly as to the treatment to be given, and finally dispose of the case, either by removing the patient or by leaving him. Usually there is a crowd about to offer suggestions and to make comments on the surgeon's appearance, or his skill or lack of it. As a training in cool-headedness, and in emergency work, nothing compares with an ambulance service. A good man is much benefited by it, one of inferiority soon finds his weak points. Some of the best of our younger men owe much to this sort of ambulance training.

In another way, it is unfortunate for the school that the city has seen fit to stop the ambulance service. The Cumberland street institution ranks as one of the most important in Brooklyn, and its ambulance, with Homoeopathic Hospital printed on the sides, kept homœopathy ever before the public. It was an advertisement, and a good one, of the school of medicine that it represented. This ambulance service was one of the most efficient in the city, and did much to make homœopathy known and respected by the old school and by the general public. It is unfortunate that it has to be even temporarily discontinued.

The Vaccination Bill.-England is excited over the vaccination bill which has just passed the grand committee of the House of Commons, conscience clause and all. This famous clause reads as follows: "That no parent or other person shall be liable to any penalty under the vaccination act of 1867 if he satisfies justices in petty sessions that he conscientiously believes vaccination would be prejudicial to the health of the child." There has been no end of controversy over this clause, and the end is not yet. But the bill will, in all probability, pass the Commons in its present shape.

The Patenting of Antitoxin.-The statement that Behring has applied for and received a patent on antitoxin is correct. He applied in 1895, and the patent was granted June, 1898. Our German friends evidently are disposed to improve the golden opportunity. But it will shock and disgust many honest physicians when they learn of this brutal action.

Dr. William Pepper.--In the death of Dr. Pepper at the age of fifty-five the city of Philadelphia loses one of its foremost citizens and the University of Pennsylvania its best and closest friend. Dr. Pepper's life was many-sided. He was not only a distinguished physician and teacher, but he was a voluminous writer, and most. of all actively interested in public affairs. While he was Provost of the University the number of students increased from 981 to 2,180, and eight additional departments were added to the school.

Malaria. In the Deutsche Med. Wochenschrift, Feb. 24, 1898, Ziemann gives a résumé of results of his studies on the malarial parasite in Italy.

The spring parasite consists of a mass of chromatin, a surround