teen cases of diphtheria which I have seen since that time, the bacilli have not survived, at the most, three applications, disappearing in some cases after one painting. The length of time for which the germs may be present in the throat without clinical manifestations varies considerably. Fullerton and Williams (Lancet, Oct. 23, 1897) mention a French case in which the cultures were positive for 15 months. Many measures have been used to destroy the bacilli, and J. Fibiger (Berl. klin. Wochn., Aug. 30, 1897), without giving it as a therapeutic hint, mentions clinical observations in which anginas, due to streptococci or staphylococci, seemed to be the final causes of the bacilli's disappearance. White (Med. Rec., Nov. 3, 1894) reported on the comparative values of hydrogen dioxid, sodium chlorid, and corrosive sublimate, with regard to the effect on the membrane and the life of the bacilli, and found that the germs disappeared a little earlier under the solutions of bichlorid than with solutions of sodium chlorid, but the risk of poisoning outweighed this advantage. Hydrogen dioxid seemed to prolong their duration. Dr. Riesman has told me of some investigations by a German, who infected wounds with various pathogenic germs, and they applied different antiseptic solutions. The most favorable effects, both as regards cultures from the wounds and the clinical course in the infected animals, was observed from silver nitrate. Since my report on this subject last June, I have had an experience somewhat similar to Dr. Swan's. I saw a clinical case of diphtheria in a family of six children, four of whom, including an 8-months old child apparently perfectly well, were found to have the bacilli in their throats. Through a misunderstanding, the druggist supplied me with a solution of thirty grains to the ounce. This was painful, and after two applications had cleared only one throat, when I resorted to the 60-grain solution, which the children said they liked much better, and after two applications all the cultures were reported negative. In reply to Dr. Welch's question I would say that my custom is to wait 24 hours after the painting before taking the culture. Current Literature Comfrey (Symphytum) in a Case of Sarcoma. In an address to the Royal Academy of Medicine in Ireland (Medical Times, Sept., 1898), Mr. William Thomson, president of that body, said, speaking of a case of sarcoma: "The growth returned; the patient then consulted Dr. Semon, of London, who advised immediate removal of the jaw. This was done after the usual methods, and the whole base of the skull was found infiltrated. All that possibly could be was removed. After a month the growth returned, bulging upon the face, almost closing the right eye. "This was in June last, and we all agreed upon a speedily fatal prognosis. Early in October he walked into my office looking better than I had ever seen him, and I was not able to identify a trace of the former trouble. He told me he had applied poultices of comfrey root, and that the swelling had gradually disappeared. "Now, this was a case of undoubted diagnosis by all the best known methods, in which the disease recurred twice, and the second time in an extreme degree; and yet this recurrent tumor has disappeared. I do not know the cause, but I do believe that comfrey root can remove a sarcomatous tumor. The fact that this recurrent tumor has not sloughed away, but simply with unbroken covering disappeared, is to me one of the greatest surprises and puzzles I have ever met with." Adonis Vernalis in Epilepsy.-Tekutiew (Brit. Med. Jour.) recorded the case of a boy, aged 10 years, who had suffered from · severe epilepsy for two years. The fits occurred 15 to 20 times a day, and there was commencing mental degeneration. A mixture of infusion of adonis vernalis with some codein and sodium bromid was given, and the dose of adonis vernalis subsequently increased. The result was most successful; the attacks of epilepsy gradually diminished, and before the patient left the hospital had ceased altogether. The treatment by adonis vernalis was strongly recommended by Bechterew, who combined it with bromids, and found that some cases of epilepsy seemed to be permanently cured by it. The Root of the Dahlia as a Protective Against Snake Venom.-Phisalix (Revue Scientifique, 1898, No. 10; Deut. Med. Zeit., July 4, finds that tyrosin, injected into guinea-pigs, is capable of rendering them proof against serpents' venom. He remarks that tyrosin is particularly abundant in the root of the dahlia, and that the fresh expressed juice of the root may be used instead of a prepared solution of tyrosin. Relationship of General Paralysis and Tabes Dorsalis.-Joffrey and Rabaud (Arch. de Neurol., July, 1898) reports a case which throws a little light upon this much-disputed relationship. A youth of only 19 years died of progressive general paralysis, having exhibited during life no characteristic tabetic symptoms. Microscopical investigation of the cord showed, however, that undoubted posterior sclerosis was present.-Medical Review of Reviews. I have the honor to announce that in April, 1898, I received from Dr. José Manuel de los Rios, Chairman of the Committee on Organization of the Third Pan-American Medical Congress, a request that, in consequence of the then existing rebellion in Venezuela, no definite arrangements be made at that time relative to the meeting of the Congress previously appointed to be held in Caracas in December, 1899. The following communication relative to the same subject is just at hand: CARACAS, September 25, 1898. Secretary of the International Executive Surgical Treatment of Pericarditis.Brentano has reported five patients treated by opening up the pericardium, with resection of the ribs, which he considers necessary, as a single puncture will scarcely ever allow the evacuation of the entire amount of pus, and incision without the preliminary DR. CHARLES A. L. REED, resection is much more dangerous and less effective. Pericardiotomy only promises success in acute cases. Two cases of suppurative pericarditis ended in death; two cases of long existing serofibrinous pericarditis were only temporarily improved; but the fifth patient was cured-a 10-year-old girl with pericarditis consecutive to rheumatic endocarditis.-Deutsche med. Woch., Aug. 11. Pernicious Anemia of the Puerperium.Vinay considers every remedy injurious except arsenic; and to avoid the almost inevitable gastric and local disturbances, prefers the rectal to the gastric or hypodermic method of administration. Large injections produce intolerance, and he never exceeds 5 grams of the dilute solution employed. His formula is: 4 grams of Fowler's solution to 56 grams of distilled water. The injections are made morning and evening for four days, and then three times a day. In very severe cases he increases the proportion of arsenic to 5 grams to 45 grams of distilled water.-Médecine Moderne, No. 54. DEAR SIR After having sent my communication dated April last, I find it to be my duty to notify you that, although the considerations pointed out in it have already ended, our country has been scourged by smallpox which has taken up all our physicians' activities and time, depriving them of going into scientific works. And as that state of mind of our people and government after such calamities as war and epidemic, would greatly interfere with the good success of our next meeting, I beg leave to tell you, in order you will convey it to the International Executive Committee, that our Government and this Commission would be grateful to have the meeting which was to take place in Caracas in December, 1899, adjourned for one year later. I am, Dear Doctor, Your respectfully, [Signed] THE PRESIDENT. DR. JOSE MANUEL DE LOS RIOS. In accordance with the request of the Government of Venezuela, and of the Committee on Organization, the Third Pan-American Medical For the International Executive Commission. THE PHILADELPHIA POLYCLINIC Brief, practical, original articles, and news of general professional interest are solicited for publication in this journal. Contributions accepted will be paid for on publication, or, if desired, and so indicated on the manuscript, Settlement will be made with advertisers in THE PHILADELPHIA POLYCLINIC on a pro rata basis for insertions given. From the business-standpoint, we shall thus 250 reprints will be furnished in lieu of other compensation, give to our subscribers threefold value for Manuscripts and other communications intended for the Editor; exchanges, pamphlets and books for review, should be addressed to THE EDITOR OF THE PHILADELPHIA POLYCLINIC, 219 S. Seventeenth St., Philadelphia, Pa. their unexpired subscriptions; the price of The Philadelphia Medical Journal being $3.00 per annum, while that of THE POLYCLINIC is but $1.00. The size of The Phila Communications with reference to subscriptions or ad- delphia Medical Journal is also threefold vertising should be addressed to BUSINESS DEPARTMENT PHILADELPHIA POLYCLINIC, 1818 Lombard St., Philadelphia, Pa. PHILADELPHIA, NOVEMBER 19, 1898 CONSOLIDATION OF THE PHILADELPHIA POLYCLINIC WITH THE PHILADELPHIA MEDICAL JOURNAL. THE Trustees of the Philadelphia Polyclinic and College for Graduates in Mcdicine have concluded with the Trustees of the Philadelphia Medical Publishing Company an agreement, whereby this journal will, on January 1,1899, be merged with The Philadelphia Medical Journal. Under this agreement, subscribers to THE PHILADELPHIA POLYCLINIC, whose subscriptions have not expired, will, after the conclusion of the present volume, receive The Philadelphia Medical Journal for the full term for which they have paid; and those already subscribing for The Philadelphia Medical Journal will have their subscriptions to the latter, proportionately extended. It is understood that this does not apply to subscribers whose payments may be in arrears, but only to those who shall have paid up in full prior to the time (Dec. 31, 1898) at which the subscription-list is transferred. New subscriptions will not be accepted after this date (November 19th), but renewals of subscriptions about to expire may be made, and will be honored. by The Philadelphia Medical Journal. that of THE POLYCLINIC. From the journalistic standpoint, we shall give them a medical newspaper unequalled in America, and not excelled in Europe. From the professional standpoint, we shall give them a teacher that will keep them fully posted on all advances in medicine and allied sciences. From the ethical standpoint, we shall give them a friend and mentor of like standard and aims to our own. Since the establishment and demonstrated success of The Philadelphia Medical Journal, the publishers and editor of THE POLYCLINIC have felt that less necessity existed for the continued maintenance of their own publication. Philadelphia, as a medical center, is now adequately represented, and by a fearless and sincere champion of the noble traditions of the medical profession. In retiring from the field, we have naturally wished to strengthen the hands of this able and honorable representative of medicine and medical journalism, and by the contract, of which notice is hereby given, believe that we have fulfilled this wish, while, at the same time, more than fulfilling our obligations to the friends whose generous support has been so highly appreciated. AS THE PHILADELPHIA POLYCLINIC Will continue its weekly visits to those friends until the conclusion of the current volume, on December 31st, we shall postpone until then the pleasant sadness of farewell. THE Medical Press and Circular has done Englishspeaking peoples an immense favor by the publication of the paper of Professor Kassowitz, of Vienna, on "Antitoxin and Diphtheria." Among other things it says: "In continuing his remarks on the serum treatment of diphtheria before the Gesellschaft der Aerzte, Kassowitz observed that he would limit himself mainly to the examination and criticism of the clinical results and therapeutical action of the serum. Before commencing he emphasized the conclusion laid before the society in his preceding lecture on the fallacy of statistics in favor of serum treatment, pointing out that the comparison was absolutely worthless owing to the large influx or augmentation of early forms which would have been excluded but for the bacteriological diagnosis of diphtheria. These cases, he observed, would, in all probability, have got well of themselves, but had been comprised in the comparative statistics in order to increase the divisor and thus reduce the quotient. He claimed to have shown that the various hospitals had received from three to six times more cases since the introduction of the serum treatment than in any other similar period." Those American physicians who are led off by every new fad and now propose to continue to use a worse than worthless remedy, a German patent medicine, "Behring's Elixir of Infantile Life," should read the Medical Press and Circular of July and August of the present year (1898), and if they can find any comfort in Professor Kassowitz's papers on the subject, we should feel disappointed. Unfortunately, the owners of patent serums control, through their advertising patronage, the columns, business and editorial, of too many medical journals, and nothing averse to the use of the various serums is allowed to appear. Patrons of journals should at least have the opportunity of reading both sides of a question. The Medical Press and Circular, like the Lancet-Clinic, plays no favorites.-T. C. M., in Cincinnati Lancet-Clinic, Oct. 2', 1898. [The above is given space not because we agree with the writer, but to "let the other side be heard." We cannot too highly commend the use of antitoxin in diphtheria.-ED. POLYCLINIC.] BOOKS RECEIVED, TRANSACTIONS OF THE PATHOLOGICAL SOCIETY OF PHILADELPHIA. Volume XVIII. Containing the Report of the Proceedings of the Society from October, 1895, to June, 1897. Edited by William S. Carter, M.D. 8vo, pp. 493. Philadelphia. 1898. PRACTICAL URINALYSIS AND URINARY DIAGNOSIS. A Manual for the Use of Physicians, Surgeons and Students. By Charles W. Purdy, M.D., LL.D. Fourth Revised Edition. With numerous Illustrations, including Photo-Engravings and Colored Plates. 8vo, pp. 365. The F. A. Davis Co., Philadelphia, New York, Chicago. 1898. CONTRIBUTIONS TO ORTHOPEDIC SURGERY. By A. Sydney Roberts, M.D. With a Brief Biographical Sketch by James K. Young, M.D. Svo, pp. 298. Philadelphia, 1898. ELECTRICITY IN THE DIAGNOSIS AND TREATMENT OF DISEASES OF THE NOSE, THROAT AND EAR. With 161 Illustrations. By W. Scheppegrell, A.M., M.D. 8vo, pp. 403. G. P. Putnam's Sons, New York, London. 1898. A PRIMER OF PSYCHOLOGY AND MENTAL DISEASE. For Use in Training Schoois. For Attendants and Nurses in Medical Classes. By C. B. Burr, M.D. Second Edition. Thoroughly Revised. 12mo, pp. 116. The F. A. Davis Co., Philadelphia, New York, Chicago. 1898. THE PHILADELPHIA POLYCLINIC VOL. VII-No. 48 NOVEMBER 26, 1898 THE NATURE OF THE LEPROSY OF THE BIBLE.1 THE Occurrence of "quick raw flesh" is by no means characteristic of leprosy, but occurs in simple ulcers, boils, carbuncles, tuberculosis, cancer, etc., etc. It might be contended that the "tsaraath" of the Bible, had undergone modifications during the lapse of centuries, and had finally terminated in our modern disease of leprosy. This is extremely improbable, as we have a thoroughly authentic and scientifically accurate description of leprosy written by Aretaeus, a Greek physician who lived in the first century of the present era. If leprosy has not changed in the slightest degree within the past 1800 years, it is not likely that it ever presented any deviation from its present picture. Aretaeus, after a classic description of elephantiasis, dramatically concludes as follows: "Sometimes the members perish before the patient, and one sees the nose, fingers, toes, feet, hands, or genitals drop off, for it is only after dismemberment of the man that death comes to him, as the deliverance from a horrible life and terrible pains. This disease has the tenacity to life that the elephant has." Ah, it will be urged: if biblical and modern leprosy are distinct diseases, how is it that the ancients and the moderns concur in ostracising and segregating those afflicted with this disease and with this disease alone? I am of the opinion that scriptural example is the sole factor that has led to the segregating of lepers to day. It was through an error that a truth was discovered, and an important prophylactic measure made a custom. It is a well known fact, that during the Middle Ages the diagnosis of leprosy was in chaotic confusion, and that in the medieval leproseries could be found examples of almost every known skin disease. Had the Bible never been written it is probable that lepers would to-day be at large. The biblical mandate brought segregation about; the verdict of science has maintained it, but this verdict has been a vacillating or, more properly speaking, an oscillating verdict. In 1867, a commission appointed by the Royal College of Surgeons of England to investigate the nature of leprosy, after an exhaustive study of the disease, reported against its contagious character. Just thirty years later, at the Berlin Lepra Congress of 1897, there was practically a unanimity of sentiment concerning the contagious nature of this disease. Such fluctuations of opinion have frequently occurred during the past few centuries. There are few scientific men who would to-day deny that leprosy is a contagious dis ease. One positive observation of direct transmission outweighs a score of negative ones. Yet it must be admitted that the contagion is accomplished with a considerable degree of difficulty, and that the conditions of susceptibility and immunity in connection. therewith are but little understood. Experimental inoculations of leprous virus upon man and the lower animals have been repeatedly negative, with the possible excep 1 Read before the Philadelphia County Medical Society, November 9, 1898. |