test. "Most ministers are dead easy blokes," said a comrade. "By an ironical propriety," says Mr. Marsh, "the lodging-houses in Philadelphia are under the supervision of the Inspector of Nuisances. There are 106 cheap ones in the city, accommodating 4,643 lodgers." He heard one superintendent of a mission deliver a tirade against "selfish wealth." At the Sunday Breakfast Association there were about 8oo in attendance who had come, as the leader said, for "spiritual food." The filth, mental, moral and physical, of the conditions at the places. liked by the beggars were in glaring contrast to those of the Wayfarers' Lodge, with its 110 empty beds. But here a work test is asked of those who are able. That selfish and lazy charity is an expensive luxury is a truth Philadelphians appear slow to learn. In Baltimore recently the blind, lame, armless, and crippled beggars were brought in by the police, and all were suddenly transformed into seeing, sound, whole, and healthy scalawags.-American Medicine.

The Passing of Formalin Injections.

Dr. William H. Park, of the division of bacteriology of the New York Health Department, has made a series of careful experiments on rabbits, which goes to show that in cases of septicemia, the intravenous injection of formalin is not only useless, but attended with considerable danger, on account of the deleterious action of this agent on the blood. The animals were inoculated with streptococcus material, and while the formalin did have some direct coagulating effect on the bacteria, it is also said to have caused more or less disintegration of the red blood corpuscles. The practical outcome of the experiments was that, instead of increasing the resistance of the system to the operation of the bacteria, formalin actually lessened it, as was shown by the fact that the infected rabbits into which the solution was not injected lived longer than those subjected to the formalin test. On the same day that Dr. Park made known the results of his researches there died in Bellevue Hospital a patient with puerperal septicemia, in whose case the formalin treatment had been employed. The condition of the woman when admitted was so aggravated that the attending phy

sician was convinced that the injection of normal salt solution, which is ordinarily used in these cases, would prove unavailing. Therefore, although from its first exploitation he had been entirely skeptical as to its alleged good results, he advised that the injection of formalin should be tried.-Boston Med. and Surg. Journal.

“Institutional Quackery.”

In 1893, according to Dr. L. D. Mason (Journal of Inebriety, January, 1903), the New York Academy of Medicine

"Resolved, That it is the sense of this meeting that all institutions for the care and treatment of those addicted to the use of alcohol, opium, or kindred drugs, should be under the supervision and inspection of a State commission, which should consist of experts in these specialties, and which should exercise its duties, under the same privileges and opportu nities as are now extended to a similar commission consisting of experts on insanity, whose duty it is to supervise and inspect the care and treatment of the insane in the various insane asylums of the State."

For ten years the abuse which this resolution was designed to prevent has been growing at an astounding rate. The greatest dignitaries of the land, as we illustrated editorially, page 994. December 27, 1902, now support institutions devoted to the treatment of various forms of inebriety by secret methods. At the meeting of the Society for the Study of Inebriety held in Boston December 18, 1902, it was again

"Resolved, That we reaffirm and indorse a resolution passed at a meeting of this society held March 23, 1893, in reference to the licensing and proper inspection of all institutions for the care and treatment of inebriates, morphia habitués, or other forms of narcomania."

Why should such institutions wish really to cure their patients? The longer their victims stay and the more frequently they relapse and return the better for the owners and stockholders. This is the sole argument needed against the support of institutional quackery. The State should assume the oversight of these places and as the first step in reform abolish secrets in the treatment of the patients.American Medicine.

The process of exhaustion may be carried to a point where the mean free path of the molecules is so far extended that they can travel inside the containing vessel with comparatively few collisions, and when this condition exists Faraday's conception of "radiant matter is fulfilled, and it is worth noting that this is also the proper degree of vacuum for the production of X-rays and cathode rays.

In 1879, some sixty-three years after the date of Faraday's remarkable conception, Sir William Crookes delivered his memorable address on 66 'Radiant Matter" before a meeting of the British Association at Sheffield, England. In this lecture he exhibited and descried very highly exhausted tubes, which were almost identical in outside form and internal construction with our present X-ray tubes, being furnished with large concave cathodes, small anodes and intermediate pieces of iridioplatinum, the latter corresponding to the targets of our X-ray tubes. He also described and illustrated the action of these tubes when energized by the high tension current of an induction coil, showing how the glass walls of the tube glowed with a bright green fluorescence, and how the piece of iridio-platinum gradually heated, became red hot, and finally melted. Sir William Crookes unquestionably produced X-rays when he made these classical experiments on "radiant matter" in 1879, but he did not chance to bring any substance within range of their influence that would have made them directly or indirectly apparent, so their existence at that time remained undiscovered.

In 1893, fourteen years after the delivery of this lecture, we hear of Dr. Philip Lenard experimenting with Crookes tubes in Heidelberg, Germany. Hertz had previously observed that the rays which emanated from the cathode terminal of a Crookes tube could pass through a very thin sheet of aluminum, placed inside the tube, and, availing himself of this discovery, Lenard made a tube with a little aluminum window in it, through which the cathode rays could shine out into the open air, whereas they had been previously confined to the inside of the tube by the glass wall which they could not penetrate. Lenard then discovered that these rays, which have been called "Lenard rays, could be deflected by magnetism, could produce photographic action, and cause

fluoresence in certain substances, platinobarium cyanide being affected in the highest degree.

Two years later we find Prof. Wilhelm Konrad Roentgen also experimenting with Crookes tubes in the Institute of Physics in Wurzburg, Bavaria, in 1895. He covered one of these tubes with black paper and noticed that when it was excited by the current from an induction coil, a piece of cardboard that had been coated with platino-barium cyanide, and which was lying on the table near by, glowed with a bright green fluorescence, although the black paper completely shielded every ray of visible light that was produced inside the tube by the electrical discharge.

Roentgen's trained intellect led him at once to connect this remarkable phenome. non with the existence of some hitherto unknown radiation, to which both the glass of the tube and its covering of black paper were transparent, and which caused the fluorescence of the platino-barium salt. Placing his hand between the glowing screen and the darkened tube he saw not only the dim shadow of his hand on the shining surface, but also the darker outlines of the bones within.

66

Thus was the X-ray at last brought to light. Foreshadowed in Faraday's conception of radiant matter" in 1816, actually produced and unrecognized by Crookes in 1879, carried to the very verge of revelation by Lenard in 1893, discovered by Roentgen on November 8, 1895.

The announcement of this discovery was made by Roentgen in a paper read at the Institute of Physics of the University of Wurzburg, in Bavaria, in December, 1895. In this paper the method of generating X-rays is explained, their fluorescent effect on a cardboard screen coated with platinobarium cyanide is described, and their action on the photographic plate is recorded as a fact of special significance. The relative transparency of various bodies to the newly discovered rays is also noted, and some negative results are mentioned regarding attempts to reflect and refract them. He also states in this paper that the term " rays" is used for the sake of brevity, the prefix "X" being given to distinguish them from the other rays, such as Lenard's, for example.

Roentgen supplemented his first paper with a second one, dated March 9, 1896, in which he presented other characteristics

of these rays, such as their ability to discharge electrified bodies by imparting conducting properties to the surrounding medium, also that they could be originated by all solid bodies, platinum standing at the head of the list in efficiency, and also suggested the use of concave aluminum mirrors for cathodes in the generating tubes.

About the middle of January, 1896, Edison brought out the present standard form of fluoroscope, which is still in general use, and Roentgen makes a special note of the value of this device in one of his papers.

Early in 1896 Edison also made a series of experiments for the purpose of discovering and classifying the various salts and minerals which are caused to fluoresce by the action of the X-rays. At this time he found that calcic tungstate possessed strong fluorescent properties, and this salt has since been used to some extent for screens. It is cheaper than platino-barium cyanide, but it does not produce such brilliant and clear definition as the latter salt.

It may be well to next briefly consider the various forms of apparatus which are in use to-day for the production of X-rays and cathode rays. We will consider three general types, and possibly mention another method of producing cathode rays without the intervention of any form of apparatus. The machines are:

1. Induction coils.

2. High frequency machines.
3. Static machines.

The induction coils of to-day differ in no respect in principle from those of many years ago. They are merely improvements on the coil as described by Faraday. An induction coil consists of a primary and secondary winding. The primary is composed of few turns of coarse wire around a central iron core. The primary, in turn, is covered by many turns-in fact, by many miles of fine wire-usually wound in segments. All parts are thoroughly insulated, a procedure attended with much difficulty in coils of great spark length. To produce a current in the secondary, the primary current must be interrupted. This is best done by a mechanical interrupter, the mercury turbine giving most satisfaction. The old-style vibrator or electrolytic interrupter may be substituted.

The current for operating the coil may be procured from street circuit, storage

battery, or cells, depending on the winding currents of various voltage; both direct and alternating can be used, the direct being much more satisfactory. The current as given off from the secondary coil is of a very high voltage, low amperage, and is a two-way current flowing opposite to the primary at the make and in the same direction as the primary at the break. The type of current from an induction coil is usually considered undirectional, but, technically speaking, this is not true, as a small amount of current is generated in an opposite direction at the break.

The next type of machine is that known as a high frequency apparatus, or Tesla coil, really a form of step-up transformer. This is allied in principle to the induction coil, inasmuch as the end result is an induced or secondary current. The current is rapidly raised in voltage by a series of steps or induction coils, finally passing through a coil of few layers of coarse wire, which induces a current of great tension and frequency in the few layers of fine wire composing the secondary winding. This apparatus may be employed on direct current if same be interrupted, but is best used on the alternating current. The current as given off by this machine is alternating and of very high frequency, producing as high as 150,000 to 200,000 surgings or more per second. This is brought about very largely by being connected. with a condenser, composed of a number of layers of tin foil, which adds very materially to the frequency.

The last type of apparatus we have to consider is the static machine. The form in general use to-day uses the Holtz induction principle, in which, by means of glass plates, a current of very high voltage and very low amperage is produced. We have the so-called self-exciting machines. and those which must first be excited by a smaller frictional machine. Without further detail I might say that for X-ray use machines with less than sixteen plates and a diameter of thirty inches should not be used. Plates of a very large diameter and a larger number of same are preferable.

If we compare the efficiency of the above described apparatus the static machine at once drops far behind the other two, both for photographic and therapeutic use. This I believe to be due to lack of current density or amperage. This can

be obtained only by using an enormous number of plates of large diameter. For photographic work the induction coil is. the best, while for therapeutic work it matters little whether the induction or high frequency be used, the high frequency being possibly preferable, owing to its greater efficiency in relieving pain.

I should like to have entered more in detail as to apparatus, but the length of my paper will not permit.

Before leaving this subject I should like to say that within the next few years we will probably see material changes in ap paratus necessary for the production of X-rays. The probabilities are that expensive apparatus will be cast aside and inexpensive material substituted. I refer to the recent discovery by Becquerel, in Paris, in which he demonstrated the radioactive properties of uranium. Monsieur and Madame Currie have recently brought forth a metal which even surpasses uranium in activity, as they claim it is one hundred thousand times as active; I refer to radium. It has also been demonstrated by Thomson that ordinary substances, like paper, thorns of trees, etc., when negatively electrified, become radio-active.

If I might briefly summarize what I have said regarding machines, I would place the Rhumkorff induction coil first. for photographic work, while for therapeutic use the high frequency would possibly hold first place. The static machine I would consider a poor makeshift for either purpose. I might say this latter type of apparatus is gradually losing its hold among operators throughout the country, with the exception, possibly, of the country practitioner. Abroad the machine has never been seriously considered.

Now that we have considered the various forms of apparatus used in generating X-rays, it may be well to say a few words regarding tubes at this time. Tubes of to-day vary but little from those made by Crookes in 1879, with the possible exception of making heavier anodes so as to withstand more powerful currents. The general type of tube is so well known as not to need further mention. The current passes from the cathode terminal to the anode, the focal point being somewhat beyond the geometrical focus. Rollins very cleverly attributes this feature to the mutual repulsion of the negatively charged particles, calling attention to this fact as

an evidence of the material nature of the cathode stream.

We speak of hard and soft tubes; this but refers to the vacuum, a hard tube being one of high vacuum and a soft tube being one of lower vacuum. This is entirely an arbitrary division.

Tubes have been constructed with various prolongations, so as to be better able to treat such parts as the larynx, vagina and rectum, but thus far they have been mere curiosities and of no practical value.

We next come to the very important subject of X-rays proper. What are X-rays, and how are they originated? I wish here again to make a definite distinction between X-rays and cathode rays. Cathode rays are the parents of Roentgen rays, or X-rays; the latter are produced whenever cathode rays strike against a solid object. The term “ X" was used by Roentgen to separate the penetrating rays from cathode rays. Cathode and Roentgen rays have many points of resemblance. They travel in straight lines, they are invisible to the unaided eye, they both affect the photographic plate, they both cause substances against which they strike to phosphoresce, and they both make gas through which they pass a conductor of electricity. The cathode rays have some powers of penetration of opaque solids, though small compared to X-rays. The differences are, X-rays cannot be deflected by a magnet or by an electric force, nor do they carry with them a charge of electricity. The penetrative power of X-rays is greater than cathode rays. Clinically I think we may also say that X-rays dave no effect on healthy or diseased tissue, while cathode rays have a destructive action.

Inasmuch as X-rays are derived from cathode rays, it will suffice to study the theories of production of cathode rays. Among the older theories they were considered to be transverse vibrations of the ether, resembling ordinary light waves, but of a much higher frequency, and therefore much shorter, while others think that they are caused by a succession of irregular and independent ethereal pulsations. The theory receiving most attention to-day is that one promulgated by J. J. Thomson, who believes the cathode ray to consist of matter in the state of hyperatomic dust, which is capable of being projected with almost inconceivable velocity in straight lines through the very