there are defective malposed or absent teeth running through several generations, the sixth year molar usually being the most frequently affected. Is the general lack of resistance to tooth decay due to loss of teeth in ancestry and consequent defective tooth structure in progeny? Condition worse with each generation. Is this not now a fixed principle in man? By estimates based on number of artificial teeth used annually, it is calculated that one hundred and seventy million of teeth are lost each year in this country. Teeth esteemed more lightly than any other organ. Effects of this enormous loss not easily determined. Possibly it results in teeth of degenerated structure, with corresponding loss of resisting power to decay and disease. The experiments of Mr. Luther Burbank seem to point to the cause of the low grade of tooth structure now found in the human race.

SOLANIN.

WILLIAM F. WAUGH, CHICAGO.

Sources from which the alkaloid is obtained; its formula; chemical properties; physiologic effects in animals and in man; toxic effects; poisoning from plants of which solanin is the toxic principle; therapeutic applications; clinical applications that have been made of the plant's contents.

Prof. F. Trendelenberg, the famous Leipsic surgeon, was the special attraction at the section on surgery and anatomy. His address was "The History and Progress of Surgery," and he said in substance:

"I am fully impressed with the high honor that has been done me in asking me to open this section. It is accepted by me as an evidence of the great hospitality which distinguishes this country above others, and of which I have had ample proof since my arrival. In an introductory address one is expected to treat of the various branches of surgery, and of the changes and advances that have been made. The antiseptic theory we look back upon as a distant dream-a dream somewhat unpleasant in character, which we would wish to forget. Surgery at that time

groped about in the dark. Since Joseph Lister the progress of surgery has been marked by one triumph after another. During recent years there has been no lack of useful discoveries. An an instance, I may mention the still increasing importance of the x-rays."

Report on Stab Wound of the Heart.

BY A. L. SHARBER, M.D.,

HOUSE SURGEON OF CITY HOSPITAL, NASHVILLE, TENN., AND RECENTLY APPOINTED PROFESSOR OF ANATOMY, MEDICAL

DEPARTMENT OF UNIVERSITY OF TENNESSEE.

John Rogers (col.), age 24 years, a resident of Nashville, was brought to the Nashville City Hospital, about 12 o'clock, Saturday night, September 8, 1906.

Examination of chest showed an incision about three inches long in the fourth interspace, just to the left of the sternum.

Condition of patient was as follows: Extreme shock-apparently in a dying condition; pulse, slow and very weak; respiration rapid and somewhat sighing, ryspnea; excruciating pain in epigastrium. The diagnosis, "Stab Wound of Heart," was made from the location of wound and from symptoms above described.

As quickly as possible I made a trap-door through the chest by cutting the sternal junction of the third and fourth ribs, then clipped the inner surface of same ribs about four inches from the sternum and turned the trap-door back upon the chest, as if on hinges. This exposed to view the lung, pericardium, and heart. The left pleural cavity contained blood, some clots; left lung was collapsed. There was a two-inch incision in pericardium running transversely. Pericardial cavity was full of blood clots. The descending branch of the left coronary artery was severed, and the wound extended into the left ventricle, just to the left of the anterior interventricular groove and somewhat below the auricular-ventricular groove, and ranged outwards (to the left)

and slightly downwards for about one and three-fourths inches. Both during systole and diastole, a small amount of blood would pass through the opening from the left ventricle of the heart.

As rapidly as possible I closed the incision into the heart with interrupted sutures, using chromacised cat-gut No. 1.

Seven sutures were taken each about one-fourth-inch apart. The sutures included the heart muscle down to the endocardium. The pericardium was closed with continuous cat-gut sutures. The operation was completed by closing the trap-door with interrupted silk-worm-gut sutures.

The patient was removed to the ward immediately. The patient to a great extent had reacted from his profound shock. Pulse was 120 per minute and of fairly good volume. Respiration was slower and deeper. He recognized and spoke to his physician, nurses and friends, and repeatedly called for water. His condition continued to improve for two hours; then he gradually began to sink, lost consciousness about ten minutes before he died, which was about three hours after operation.

Selected Articles

A BRIEF RESUME OF THE WORLD'S RECENT CANCER RESEARCH.

BY WILLIAM SEAMAN BAINBRIDGE, M.S., M.D.

PROBABLY no disease has received more scientific investigation within recent years than cancer. Thousands of individual observers and a number of special commissions, both in Europe and America, have been devoting their entire time to the solution of some of the complicated problems of cancer. The work has largely been one of negation. Certain general facts relative to the occurrence of cancer have come to be accepted by investigators both in Europe and America. Some of the theories concerning the etiology of cancer have been practically disproved, while others are still under consideration, the final verdict being sub judice. Many of the agents which seemingly gave promise of great usefulness have been proven inefficient, while others have been more nearly restricted to their legitimate field, which, in most cases, is a very limited one.

In a study of the recent literature concerning the various phases of this interesting subject one is fairly overwhelmed by the mass of material, statistical and otherwise. It would be impossible in a paper of this scope to do more than epitomize this world-wide research.

Occurrence.-Cancer occurs with the same essential characteristics throughout the vertebrate creation. It is found in all domestic animals, in wild animals, and even in fish, and in its development accommodates itself to the life-span of the individual animal. It occurs in animals with increasing frequency as age advances, whether the duration of life be long or short. In man malignant new growths are found in considerable numbers. after 45 to 50 years; in the horse, dog, and cat after 9 years; in the trout after from 5 to 7 years; and in the mouse after 2 years. The maximum incidence, whether in man or animals,

coincides with the decline of reproductive activity, and yet castration seems to have no influence in the time of occurrence of the disease. The fact that both carcinoma and sarcoma are found throughout the vertebrate creation, increasing in the same manner as life advances, suggests their similarity.

Cancer is comparatively rare in hot countries, especially in those whose inhabitants subsist largely on vegetable diet. With certain exceptions it seems to be prevalent where animal diet is mostly consumed. In this connection it may be stated with reference to the influence of diet on the development of cancer that there is a variety of conflicting testimony. From those who believe it traceable to the uric-acid diathesis, advocating a vegetable diet as a preventive, to Senn, who finds that the Eskimos, living on an almost exclusive raw meat diet, are absolutely immune from tumors of all kinds, there is a variety of opinions. In Borneo cancer is apparently unknown; in certain parts of China, Burmah, and India it is very rare; in Persia it is seldom seen, and in Africa it is much less common than in many parts of Europe. In Germany it is less frequent than in England or Sweden.

Black races are remarkably immune from cancer, yellow races are more prone to it, while the white races are the most liable.

It occurs when the tissues are undergoing retrograde metamorphosis, hence it is largely a disease of senility. Both carcinoma and sarcoma occur with increasing frequency as age ad

vances.

It seems to be the consensus of opinion, among both European and American investigators, that cancer is undoubtedly on the increase, a fact not entirely accounted for by the present better diagnostic methods and the more accurate keeping of records. In the United States cancer is distinctly on the increase, census reports showing that from 1850 to 1890 the mortality from cancer increased from 9 to 33.5 to every 100,000 population. In England and Wales returns from the Registrar-General show the following annual ratio of deaths from cancer to each million of persons: In 1864, 385; in 1895, 755, and in 1900, 828. In