The wound was dressed carefully, using every aseptic precaution. After reaction the patient seemed in good spirits and in good general condition. The temperature ranged about 1001⁄2°, respiration normal, bowels moved naturally, appetite good and slept well. It was necessary to evacuate the bladder with a rubber catheter twice a day. The patient was taught to use and care for the catheter because the distance was too great to make two trips a day. The patient suffered pain only in the right extremity, otherwise he was quite comfortable. The wound of entrance healed in a few doua disturbance. The pain and hyperesthesia of limb decreased somewhat during the first two weeks. At the beginning of the third week the patient called my attentiono the presence of pus in the urine, but this was thought to be from cystitis a complication so commonly met with in injuries of therARY

The blisters on his feet did not heal, but became gangrenous. At this time hemorrhages from the bowel commenced and persisted in spite of treatment, becoming more alarming in quantity and frequency each day, and on the 21st day the patient sank rapidly and died. The history of the symptoms just preceding death could not be gotten, but evidently they were those of intestinal perforation. A request for an autopsy was granted, and was made with the assistance of Dr. A. J. Hager, with the following results:

The wound of entrance which had healed was focated five inches below the left nipple and six inches to the left of the median line. The ball struck the eighth rib, which it perforated, beyond which the track of the ball had disappeared, having healed. The course of the ball was again found passing in front of the left kidney, crossing its upper pole, passing between the kidney and the descending colon. The track of the ball was then traced through the left psoas muscle and found to enter the intervertebral foramen between the first and second lumbar vertebræ, traversing the spinal canal it cut the anterior portion of the lumbar enlargement of the cord and emerged from the canal, passing out of the opposite intervertebral foramen and lodging in the right psoas muscle about two inches from the spine. At the point

where the ball passed behind the colon there was found a gangrenous patch in the wall of the colon and a perforation. The kidney was next examined, a dark line showed across the anterior surface, the capsule was not cut, the ball just touched it. On opening the capsule the kidney substance was almost entirely destroyed by inflammation and the capsule was filled with pus. Pus was also found in the spinal canal within the dura, the injury to the cord did not seem extensive. From the autopsy it is evident that the ball perforated the eighth rib and passed between the descending colon and the left kidney, bruising both of these structures, and passed through the left psoas muscle, entering the spinal canal by passing in at the intervertebral foramen between the first and second lumbar vertebræ and passing out at the opposite foramen, wounding as it passed the anterior surface of the conical termination of the spinal cord, lodging finally in the psoas muscle. The injury to the cord seemed slight but it was sufficient to cause a paralysis both motor and sensory of the entire left lower extremity. This could hardly have occurred if the injury had been confined to the cauda aquina. The symptoms being unilateral is a puzzling feature, as is also the pain and hyperesthesia of the right extremity, but this last could result from injury to the right lumbar plexus. The disintegration of the left kidney, especially at such a late date, is interesting.

Here the capsule was perfect, but the kidney tissue had nearly disappeared and the capsule was filled with pus. Pus showed in the urine not sooner than two weeks after the injury, showing that either pus had not formed or the kidney was not functionating.

It is possible the trophic influences being disturbed brought about this rapid degeneration. Finally the presence of a large blister on the ball of the left foot and another on the right at the base of the great toe, present another problem. These were noticed. in two hours after the man was shot; he could not have walked on them without rupturing them, and later these points both became gangrenous, leading to the belief that they were trophic in origin.

Selected Articles

THE ANTIQUITY AND FALLACY OF ANIMAL EXTRACT THERAPY.*

BY W. G. M'FADDEN, M. D., SHELBYVILLE, IND.

ALTHOUGH it is discordant with medical opinion and humiliating to our profession that any of the tenets of Homeopathy should have a place in educated medical practice, yet we must admit that the most modern phase of therapeutics tends in this direction.

The fashion has lately been to prescribe for the disease of any organ an extract from the active principle of a corresponding organ in man or beast, and pharmacists who cater to the therapeutic ideas of the first decade of the twentieth century are offering to our profession various preparations of the alleged active principles of all the glands found in the human and animal body.

A London firm of pharmacists gives a list of animal extracts containing twenty-one of these preparations, including every organ and gland of the body, and the medicinal virtues of all these compounds have been lauded by some of the most prominent physicians of England and the Continent. While the pharmacists of the old world have been providing our profession there with these preparations, the pharmacists of this country have not been idle, and are supplying our " up-to-date" physicians with a "full line" of these animal extracts; and as there is a tendency among those physicians who have no well-digested views as to pathology and therapy to make shot-gun prescriptions, one of our leading firms has come to the rescue, and are supplying us with Protonuclein, which compound received its name from its supposed resemblance to Professor Huxley's principle of protoplasm.

* Read by title before the Mississippi Valley Medical Association, at Indianapolis, Ind., October 10-12, 1905.

But, unfortunately, from this theory came the suggestion to him to supply to the diseased organ the extract of a healthy gland as a physiological substitute for the diseased gland; and he and his followers claim that the administration of these animal extracts have no appreciable effect on those whose glands and other organs are in a healthy condition, which is Homeopathy pure and simple.

The champions of animal extracts claim that their resistance to pathogenic germs is now conceded by all pathologists and therapists who "keep abreast of the times," as modern physiology has demonstrated that the gland-cells furnish a secretion which finds its way into the blood and plays an important part in developing normal metabolic changes in all the organs of the body; and they claim that this theory is supported by the fact that the injection of the extract of any gland is very beneficial whenever the function of that gland is impaired, and that extirpation of a gland is always immediately followed by constitutional disturbances and great impairment of the particular function over which this gland is supposed to dominate and control.

A few years ago Dr. Theodore Clemens published an article in one of the German journals in which he recommends the injection of freshly prepared urine of a child into the bladder for the cure of chronic cystitis in aged persons.

A young physician reports lately in one of the French jour nals that he injected, hypodermically, some of his own semen into his invalid wife's body, and states that her strength rapidly improved, and after four injections she was entirely well.

But we need not go to the old world to find advocates for the animal extracts. The late surgeon, General Hammond, believed that the animal extracts contained almost unlimited medicinal properties, his favorite one being cerebrin, or brain extract.

Dr. Solomon Solis Cohen read a paper a few years ago before the American Medical Association on the use of animal extracts, in which he stated that one of his patients who was suffering from exophthalmic goitre was rapidly improving under the use of the thymus gland. He said a relapse suddenly occurred one

day, and on visiting his patient he found that the druggist, or butcher, had sent his patient a thyroid instead of a thymus gland!

It is a significant fact that we find in our medical journals within the last few years an account of more cases of myxedema than can be found in the preceding century, and in confirmation of this assertion I will state that Dr. Osler reported in one of the late Johns Hopkins Bulletins that he had been unable to find but eleven cases that had been diagnosed as myxedema on this continent in the last hundred years, after diligent research and correspondence with representatives of the profession throughout the United States. This could also be said of hydrophobia, both of which seem now to be almost as common as appendicitis.

Has the belief that we have found a specific for these diseases anything to do with this? Statements like these coming from such men as Osler are calculated to cause the thoughtful physician to have but little confidence in the wonderful cures claimed for the animal extracts. And when we read that an eminent specialist of this country is now using injections of double distilled extract of gonorrheal pus in the treatment of rickety children whose fathers had gonorrhea in their youth, we become thoroughly disgusted and ashamed of this revival of ancient therapeutics.

I alluded in the first part of this paper to the antiquity of animal extract therapy, and now will as briefly as I can give a few historical facts in proof of some assertions I have made; and I deem this proper on this occasion, from the fact that a great many physicians of this country have fallen into the same error that the learned editor of one of our prominent medical journals has, who stated in a recent editorial that the use of the animal extracts originated in 1891, with Brown-Séquard; but if he had been familiar with the history of our profession he would have known that the animal extracts, especially those of the testicles, were used by the Greeks and Romans more than two thousand years before the birth of Christ.

Brown-Séquard did not invent this theory. He only was among the first in modern times to hear the erotical refrain as