physician, if he trusts to ordinary methods of examination entirely, A patient quite far along in the prodromal stage of paralysis, in this way, was erroneously made the subject of a clinical lecture, as illustrating physical and no mental signs of general paralysis. Another went almost directly from the consultation-room of a distinguished neurologist, with a certificate that he was of sound miud, to make some most unwise and embarrassing contracts, and then, after the excitement and exhaustion of a long railroad journey, wrote a letter giving his friends much anxiety, and causing them to at once hunt him up and take him home. He performed his clearly irresponsible act in such a seemingly responsible way in all particulars, that it would probably have been impossible to have had it correctly estimated by the courts. He has since died, a typical general paralytic, with all the symptoms of the books. Dr. Charles F. Folsom in The Boston Medical and Surgical Journal. SYPHILIS AND MARRIAGE. From a series of lectures on hereditary syphilis, delivered at l' Hospital St. Louis, in Paris, by Professor Fournier, and translated for the Weekly Medical Review: The physician ought not to permit marriage to his patient, until by reassuring circumstances he has become inoffensive as a father and a spouse. Alas! Many of our confreres are on this point sadly tolerant. Marriage is permitted at the end of two years, one year, and even after several months. Treatment during a few months or even several weeks has been deemed sufficient! This is a great fault. The tolerance and complaisance of the physician in each case is a crime! It only results in letting the subject engage himself in a series of irksome, humiliating and painful scenes, poison his wife, see his children die at their birth or before they are born, or behold the nurse contaminated by the disease. I have seen many such dramas, and I can assure you that no situation in life is so heart-rending as that of a man who has introduced syphilis into his young household. Vis-a-vis to his wife who does not or will not understand what causes all these troubles; vis-a-vis to his new relations, who see and judge severely; vis-a-vis to a child who has the aspect of an old man, sickly and debiliated; vis-a-vis to a nurse who reveals everything and covers him with shame and disgrace. Now think of the responsibility of the physician who knows that all this could, nay would happen, and who has given no warning! Is he not the greatest culprit? It is therefore a strict professional duty to interdict marriage until the patient has become inoffensive.-N. W. Lancet. THE DISEASED MEAT SCARE.-The Nineteenth Century recently published as its piece de resistance an article on the diseases conveyed by butchers' meat. The author, Dr. Behrend, is unknown to us as a pathologist or sanitarian, but he seems to have collected industriously all the facts obtainable regarding tuberculosis of cattle, and the dangers to human beings of infection therefrom. He quotes a statement recently made before the Berlin Medical Society to the effect that, in some parts of Germany, one-half the cattle are tuberculous; and adds that the only Continental town in which "a systematic inspection of all dead meat is enforced" is Hanover, where a careful examination of the various organs is made by experts, who are continuously employed, and meat cannot be sold unless it bears a stamp affixed by them. In one month, at Hanover, 8000 pounds of meat were condemned as tuberculous. Eight thousand pounds means, however, only nine or ten cows. "But," says Dr. Behrend, "if we apply the Hanoverian standard, we shall find that 7500 head of cattle thus affected are eaten by Londoners every year, and that, at the ordinary rate of computation, at least 375,000 of the inhabitants of the metropolis run the risk of being tainted with consumption. Now, all this is very interesting and important, and Dr. Behrend's article has excited much talk and learned editorial writing in the daily press. But it is yet unproved that the meat of tuberculous cattle ever caused tuberculosis in man. Bovine tuberculosis is generally pulmonary. Tuberculous bacilli are found sometimes in the glands, but practically never in blood or muscle, except in acute general infection. Even if the bacilli do get in meat muscle, Nocard, who is an ingenious and skillful bacteriologist, has shown that they are destroyed or digested in the tissue. And Nocard has positively affirmed that one can safely eat the flesh of tuberculous animals, the tubercles of which are limited to the viscera and lymphatics. High temperatures destroy the bacillus also, and, therefore, thorough cooking would make even the tuberculous tissue safe. Dr. Behrend ought to know, also, that tuberculous meat can only infect the body through the alimentary tract; but Koch has shown that adult bacilli are destroyed in the stomach, and that the spore bacilli can only get through alive by a narrow margin. But, furthermore, if tuberculous meat were so dangerous, there should be more primary intestinal tuberculosis. In adults this disease is a great rarity, and, practically, it may be ignored. Even including infants it does not make up ten per cent. of tubercular diseases. We venture to say, therefore, that the 375,000 Londoners who possibly ate the presumably tuberculous meat, digested it and its bacillus, and were the better for their repast. It must be very evident, we think, that the danger to adults from eating flesh of tuberculous cattle, is so extraordinarily remote that it may be practically ignored. The liver, "lights," and glands of such cattle, however, are perhaps not so safe, and sausage made up from meat seriously affected may not be free from danger. We advise, therefore, as we have done, the governmental inspection of slaughter-houses; but we much more seriously urge the supervision of milk. This, it is known, can carry the tuberculous virus, and, being consumed uncooked by delicate and growing children, is a far more dangerous product than the flesh of tuberculous cattle.-Medical Record. THE RELATIONS OF INFLAMED TONSILS TO RHEUMATISM. A comparison of the experience of various observers in regard to a given subject is always of value, especially when the personal equation is reduced to the minimum and the collated experience may be verified-without deductions for errors of observation - by any interested student. Of such a character was the discussion on 66 'Tonsillitis, its Varieties and Relations to Rheumatism," that took place at the recent session of the Laryngological Section of the British Medical Association. Dr. C. W. Haig Brown classified tonsillar inflammations as simple and specific, the latter being sub-divided into exanthematous (scarlatinal, morbillous, etc.) and diphtheritic, also as sporadic or epidemic and as follicular or interstitial. The follicular variety, he said, was most common, and the disease appeared when the air was saturated with moisture, in December and January, and again after hot, dry days with high humidity. Drain poisoning frequently caused the disease; and he referred to an institution in which the repair of improper drainage had reduced the percentage of amygdalitis to five and rheumatism to one, against twenty-one and four before the repairs were made. Of 119 educated persons with inflamed tonsils, 28 had rheumatoid pains with the attack, 38 had had previous attacks of rheumatism, and 10 had rheumatic parents, though they were free from this disease themselves. The aptitude of each disorder to recur, the sour-smelling perspiration, the pain in the back and limbs independent of arthritic pain, due to inflammation of the fibrous elements of the muscular fascia, the occurrence of cardiac murmurs in amygdalitis, as well as of endocarditis and pericarditis in rheumatism, lent a similarity to the diseases that outweighed their points of difference. He had not found that the salicylates, beyond their sedative power, influenced amygdalitis. This causative and clinical relationship led to the conclusion either that rheumatism as frequently found expression in the throat as in the fibrous or serous membranes, or that the inflamed tonsil, having received the rheumatic poison, became the medium of its transmission to the circulation, or that specific germs manifested their presence by inflammations of the tonsils and the fibrous and fibro-serous membranes. The last, by analogy with other diseases, seemed the most probable conclusion. Dr. A. E. Garrod acknowledged the frequent association of sore throat and rheumatism, and reviewed the various observations that had referred to this association. He considered that the fact that many sufferers from rheumatism had amygdalitis was evidence that the arthritic pain accompanying the latter was rheumatic, and that the frequent association of pharyngitis, amygdalitis, and rheumatism was evidence that the former was a manifestation of the rheumatic state, though it was, of course, conceded that there were many cases of sore throat that had no connection with rheumatism. When sore throat was the leading feature of the attack there was little tendency to affection of the endocardium or pericardium. No importance was attached to arguments based on the results of treatment. Mr. Lennox Browne, who professed to have been the first to insist upon the etiological, semeiological, and therapeutic analogy between tonsillar inflammations and the rheumatic diathesis, agreed with Sir Andrew Clarke that the sudden suppression of the generation and discharge of lymph-cells by the tonsil, the accummulation of effete matters in the crypts, and the filling up of lymph spaces with the products of bacterial life and evolutionary matter contaminated the blood and originated the rheumatic troubles. He believed that the action of sodium salicylate in inflammation of the tonsils proved the rheumatic character of the disease. Dr. R. Hingston Fox referred to amygdalitis accompanying the exanthemata, distinguished between epidemic sore throat and simple tonsillar inflammation, and accepted Dr. Cheadle's seven phases of the rheumatic series: endocarditis, pericarditis, pleurisy, amygdalitis, exudative erythema, chorea, and subcutaneous nodules. In this series the lymphatic system, with which the tonsils, the ileo-cecal glands, the serous cavities, and perhaps the joints, were connected, was especially concerned. The association between these diseases was further shown by the facts that often one individual was attacked at different times by two or more of them, and that several members of one family might be attacked by them. Other speakers expressed themselves to much the same purpose. While there is a consensus of opinion regarding the association of the diseases in question, and the importance of inquiring about rheumatic symptoms in amygdalitis is emphasized, yet the latter symptoms seem to be the result of a ptomaine poisoning. A more extensive study of both diseases is necessary to arrive at an exact conclusion regarding their pathological identity.-N. Y. Med. Jour. A SHOTGUN PRESCRIPTION FOR ASTHMA.-The following compound, to the knowledge of the writer, has apparently cured a long-standing case of asthma: The prescription was made by an old school-no a "physician " (not surgeon)-of Oakland, and was given to the writer by one who knows it to be the formula which made the cure. There is nothing new about it, but the combination seems to be felicitous. Try it and let us know whether it succeeds or fails, if you have a stubborn case of asthma on hand. day. R Potass iodid.. . . . . . ... 3 vi. Tr. belladonna and liquor potass. arsen..aa 3 ss. Elix. calisaya, ad.. ...... 3 iii. M. Sig-Tablespoonful in one-half a glass of water three times a The dose taken by the patient referred to was a single tablespoonful at bed-time. His case has been a very stubborn one, as we have known, Misce. Sig. A teaspoonful every two, three or four hours as neces sary.-N. W. Med. Jour. |