as in metropolitan cities, and lithotomy was skillfully performed at the cross-roads of Kentucky. But in the evening of their day an inexorable fate decreed that they should be spectators of and actors in the most tragic period of their country's history, the darkest picture in the book of their nation's career, that of war, cruel civil war, dreadful fraternal war. O acme of human horror! Acme of human sorrow! Time that at last makes all things even, and that unto us all kindly brings healing in its wings, mercifully has woven a veil over these sad, sad years of strife and sorrow, which God grant may never be drawn aside, but through which will shine and will be forever memorable daring deeds of heroism, of self-sacrifice, of loving ministrations of mercy, noble efforts of humanity, beautiful exhibitions of fraternal love and kindness, which were living forms among the dead stars above the storm. The sanitary arrangements of the camping-ground when the hard day's march was over; malaria baffled in the marsh; expeditious and comfortable transportation of sick and wounded; the extemporized camp hospital equipment. The admirably arranged general hospital; care of wounded under fire; those mortal terrors, pus blood-poisoning, erysipelas, banished from the wards; every cavity penetrated by a missile was entered, the injury repaired, and lives saved. war. Through this grand and heroic race of men coursed love's double current: Love for their professional brethren and love for humanity, for the heart that would preserve the one must to the other cling. It was a mystic cord going forth from them that encircled and embraced in its ample and ever-widening folds the physician and surgeon from every section of this country who played a part in the drama of the civil Because they know only the union of hearts, the union of hands, the union that nothing could sever. They knew no North, no South, no East, no West. They had passed the last ounce of quinine and the best case of surgical instruments across the picket line. They heard the universal command on every stricken battle-field, "Bring in the wounded, friend and foe." They saw the surgeon in gray who was riding with Lee get down from his horse and put his canteen to the lips of the wounded and dying soldier from Maine amid the fiery hail at Gettysburg. Long and lovingly could I linger amid scenes and memories such as these of a generation that soon will be venerable; near and dear they are to your hearts and mine; garlands they are, gathered from the garden of delight to strew them in your pathway to cheer, to comfort, and to encourage you to nobler efforts and to higher endeavor, to lives grander here, brighter and happier in the land of the hereafter, whither we are all rapidly hastening. Some of us have known them, all have heard of them, and now, now and here, we all with loving hearts unite to weave the laurel chaplet for their honored brows. Fathers and brothers of a former generation, benefactors, all hail and farewell! In their day, and for their age and for the future in the distance they wrought nobly and bravely, usefully and successfully. I do congratulate you, my Fellows, that you have come to the kingdom at such a time as this. Because they prepared you for and projected you into the twentieth century, which I believe is destined to become the most wonderful and the most beneficent era that the medical world has known, since Jenner in 1798 proclaimed to plague-stricken nations the greatest scientific discovery ever made by man; when the secrets of the bacteriological laboratory shall be revealed; when the magnificent anticipations for the serum-therapy shall be realized; when tubercle, cancer, and leprosy shall be transferred from the catalogue of incurable to curable diseases; when the searchlights of higher medical education, of biology, of histology, and of chemistry shall surely illumine so much that now is obscure, then the watchword will be Progress. "A point which yesterday was invisible is its goal to-day, and will be its starting-post tomorrow." Then, indeed, will the Tree of Life afresh put forth its leaves that shall be for the healing of the nations. They thus bid you enter into and possess a Canaan fairer than they had seen, blessed with far richer fruits, far greener shades, and far fresher flowers. And earnestly do I pray, God grant that he who shall stand before this Society at the close of this present generation of Kentucky physicians as I, welcomed, honored, and greeted, have been this evening, shall gratefully tell of greater triumphs, shall relate more brilliant discoveries, and proudly speak of more glorious successes and victories achieved by them for God, for country, and for humanity. For these LEXINGTON, KY. "Better far than Glory's pomp shall be TANNIGEN: A NEW INTESTINAL ASTRINGENT. BY DR. DE BUCK. Up to within the present time we had in our materia medica no perfectly reliable intestinal astringent, and yet by numerous examinations of the various accessible mucous membranes it has been demonstrated that one of the best antiphlogistic measures, it matters not what may be the cause of the inflammation, is to be found in the influence of astringents. The astringent effect produces a dessication, a thickening, a constriction of the superficial tissues. The explanation of these phenomena is to be sought in physico-chemical processes (Schmiedeberg, Harnack). The astringent action is produced by various substances which form insoluble and firm products with the elements of the tissues. These are chiefly the salts of alum, several of the heavier metals, and tannin. All these substances possess the property of precipitating albuminous bodies, mucin and gelatine with formation of metallic albuminates, tannin albuminates, etc. The astringent influence consists in a precipitation at the level of the most superficial layers of the tissues. If under the influence of large doses the coagulation is very decided and extends to the deeper part of the tissues the effect becomes caustic, giving rise to gangrene, ulceration, etc. The retraction and induration of the mucous membranes under the influence of astringents is directly opposed to congestion, exudation, hypersecretion, which accompany the inflammation. Moreover, the superficial layer of the mucous membrane, in consequence of this shrinkage, forms a protective covering for the deeper-lying sections. The irritative processes evoked by noxious materials are alleviated, the nervous system fibers and ganglia of the mucosa are less irritated, and the reflex is diminished; a condition of comparative rest of the organ occurs, which is a favorable prerequisite to the restitutio ad integrum. The micro-organisms and their excretory products are hindered in their injurious effects; the mucosa, modified by the astringent, has become a poor culture medium; the diminution of the exudation and secretion reduces to a minimum the pabulum indispensable to the development of the micro-organisms. Aside from this the majority of astringents have a direct antiseptic influence. This property is also shared by tannin, although in a less degree, and perhaps also by tannigen. Furthermore, tannin possesses a restraining action upon the diapedesis of the white blood corpuscles, a property which is likewise ascribed to a physico-chemical modification of the capillary walls. From what has just been said it will be readily understood what advantages can be expected from a reliable astringent in the treatment of inflammations of the intestinal tract, provided that their effect will be local and topical upon the mucous membrane. But there is great difficulty in fulfilling this requirement in the case of the intestinal canal. It must be remembered how long is the distance to be traveled by the astringent before it can reach the seat of the trouble, and hence it may be absorbed, precipitated, and neutralized before it arrives there. Its influence will be expended upon the mucous membrane of the mouth, esophagus, and especially the stomach, and will be followed by more or less severe disturbances of the digestion. The same objection is encountered in the application of intestinal antisepsis. In late years, however, pharmacology has supplied us with various antiseptic remedies which pass through the upper portion of the digestive tract (stomach) without decomposition, which possess a neutral reaction and therefore exert no influence upon its digestive functions. They are decomposed only in the presence of the alkaline juices of the upper sections (duodenum, etc.) of the intestinal tract. Moreover, this decomposition proceeds slowly, and substances which result therefrom are able in this manner to exert their antiseptic action upon the entire length of the intestinal canal. The substances of this kind comprise aromatic ethers, salol, vetol, cresalol, benzonaphthol, etc. They are quite serviceable in the treatment of intestinal and also vesical infections. It was therefore rational to apply these principles in the discovery of an intestinal astringent, a derivative of tannin, an aromatic acid, digallic acid, C.H2(OH),CO, OC,H2(OH)2, COOH, which contains ethereal hydroxyl groups. H. Meyer, of Marburg, was the first to utilize these rational principles. He experimented with the pentacetyl derivative prepared by Schiff in 1873, but found it completely inefficient in his experiments on animals in consequence of its insolubility and difficult saponification. He then prepared the diacetyl derivative of tannin, which is the most readily soluble and most easily saponified. Meyer called this product tannigen (CH[CH.CO],O,). Tannigen is a grayish-yellow powder, odorless and tasteless, slightly or not at all hygroscopic, melts at 1870-190°, is very slightly soluble in water and dilute acids, soluble in alcohol and in dilute solutions of sodium phosphate, carbonate, and biborate, etc. It is slowly saponified in the presence of heat and when allowed to stand in the cold in the presence of alkalies with a formation of acetic and gallic acid; in the presence of ammonia tannin is formed. On addition of iron it gives the same reactions as tannin. The alkaline solutions of tannigen have distinct astringent properties, precipitate albumins, mucin, and gelatine. By addition of alkalies or borax the precipitate is redissolved and the astringent action restrained, as in the case of tannin. Experiments on animals by Meyer showed, in conformity with these theoretical anticipations, that tannigen does not affect the gastric functions, but exerts an astringent influence extending down to the lowest portion of the intestinal canal.. A small portion of the dose is even excreted with the feces. The greater portion is progressively saponified during its passage through the intestine, and after its absorption is eliminated by the urine in the form of gallic acid. Clinical observations soon confirmed the experimental results of Meyer. Fr. Müller employed tannigen in the medical clinic of Marburg, especially in chronic diarrhea of various kinds. He often obtained successful results in the course of twenty-four hours, but found that this improvement was only transient, and that to obtain a cure it was necessary to continue the drug for several days. Diarrheal affections, and even those of a tuberculous character, were favorably influenced. The remedy was readily taken, and produced neither habituation nor injurious after-effects, even when used for a long time. Künkler, in a medical clinic of Bonn, obtained no less favorable results, both in acute and chronic diarrhea in children and adults. Drews, of Hamburg, employed tannigen in fifty-five cases of enteritis of various kinds in children with marked benefit, and in fifty-three cases effected a cure in the course of a few days. The doses prescribed by the above named authors varied from 0.1 to 0.5 gram, and even 1.0 gram, three to four times daily. (Gr. 12,7%, 15.) I have also investigated the utility of tannigen. I employed it in a few children, in younger adults in my polyclinic, and in a few adults in my private practice. The following is a description of these cases: I. Children and Adolescents. 1. E. C., aged fifteen; first seen July 10, 1895; diarrhea since ten days; ten watery, almost colorless stools daily; no tenesmus; spontaneous pains and tenderness over abdomen, |