it to be entirely free, producing in due course perfectly typical attacks identical in character with the patient from whom the blood was originally taken. In other words, we have combined two steps necessary in Koch's law; we have not cultivated the organism in a suitable culture-medium outside the body, and then introduced it into the body of some animal or person and reproduced the disease, but we have in a sense made the person his own incubator. We have injected him with blood in which the plasmodia were circulating, and as soon as they passed through their life-cycle in his blood they have developed the disease in him.

Concerning the transmission of malaria by air and water: The profession was fully imbued with the idea that water was responsible for the disease. We used to fight over that a great deal. But as far as I know the pendulum has now swung further away from that position, until it seems to be pretty well settled in the minds of those who are entitled to speak with authority that while the aerial transmission seems to be excluded, there is a possibility of infection by water, but you will hardly find anybody who is willing to stake his reputation on it.

I did not know before that there were no gnats, as I believe the English usually call mosquitoes, in Ireland, but it has been suggested that other suctorial insects can transmit the disease; it has been said that the bedbug is capable of harboring the plasmodium, that he will bite a person suffering with malaria, take up the poison and transmit the disease to the next person he bites, and so on. That is to say, that he merely acts as a carrier of infection, and is not, like the mosquito, a definite host; just as Findlay explains those cases of experimental yellow fever which develop before the incubative period in the mosquito can elapse.

To say that we have no mosquitoes at any time of the year is a very wide statement. We have had some very cold weather in Louisville for the past few months. I have now in my laboratory a mosquito that was caught flying around the wards of this hospital a week ago. I have no doubt that many of them might be found in various places, cracks and corners, even during this cold weather. Some repairs to the attic, just over the ward, had probably dislodged her from her hiding-place, and finding the air of the ward warm she tried her wings. They have been found in Baltimore in cold weather; they have been found in New Hampshire when the thermometer was down to zero.

I recite the following case to emphasize the importance of examining the blood in obscure cases, especially in a malarial country: A youth was brought into the United States Marine Hospital at Memphis; he had complained of a little malaise for a few days, but did not appear to be seriously sick. He was a healthy-looking, robust fellow. The next day he developed a perfectly typical hemiplegia, the face and arm of one side and leg of the other. Sensation was much impaired, motion entirely lost. I examined his blood at once, and found he was

simply alive with the plasmodiæ. I treated him with quinine in large doses hypodermatically, and in a few hours he had greatly improved; in twenty-four hours he had entirely recovered.

In this connection I desire to say a word of caution in regard to methyl and methelene blue. Methyl blue is a violent poison and should never be used; care should be exercised in writing prescriptions and methelene blue should always be plainly specified.

P. F. BARBOUR, M. D., Secretary.

Abstracts.

Actinotherapy: Gottheil: In a preliminary communication upon the use of concentrated light in the treatment of dermal affections W. S. Gottheil briefly reviews the work done by Finsen, Kime, and others in this field, and describes the arc light that he employs for the purpose. This is at present the only available source for the actinic rays of sufficient volume and intensity for therapeutic employment. Sunlight is, of course, the best and is costless; but it is too uncertain for satisfactory use. No combination of incandescent bulbs run on the ordinary continuous or alternating commercial current is sufficiently actinic, and the apparatuses arranged with them practically give us heat and no light baths.

The author employs an apparatus called the actinolyte, made by Kliegl Bros., of New York, which can be adapted to either the continuous or the alternating current, uses from twenty-five to fifty-five amperes, and gives a concentrated circle of light of from 20,000 to 30,000 candle-power. He is not prepared as yet to publish his results, but the progress of cases of lupoid and syphilitic ulceration has been most encouraging. The cosmetic results of this non-operative and

painless method of treatment are especially good-a point of the greatest importance, of course, when the face is involved. (The Medical News, July 6, 1901.)

Dühring's Disease in Childhood: Gottheil: Dermatitis herpetiformis, first described by Professor Dühring, of Philadelphia, is probably of commoner occurrence than is generally supposed, more especially in children; two cases are described by William S. Gottheil, of New York, in the June number of the Archives of Pediatrics. The resemblance at first sight to an ordinary eczema, dermatitis or impetigo is marked, and doubtless cases of the disease are not infrequently so classified. The points which distinguish the less common affection are:

1. The extreme obstinacy and chronicity of the malady; it being prolonged almost indefinitely by successive exacerbations or relapses. 2. Its original herpetic character and subsequent multiformity of lesions.

3. The intense pruritus.

4. Its recalcitrancy to treatment.

Any apparent eczema, dermatitis, or impetigo in children presenting these features should be carefully observed; a certain number of them will undoubtedly be found to be cases of Dühring's disease.

The Curability of Syphilis: Gottheil: Speaking of the curability of syphilis, in the symposium upon that disease in the October number of the International Medical Magazine, William S. Gottheil, of New York, takes exception to the opinion of its practical incurability which is prevalent in certain quarters. Every-day experience shows that the great majority of cases are cured in every practical sense, the occasional late relapses and accidents to the contrary notwithstanding. He concludes:

1. Syphilis is a curable disease, and may even, with restrictions, be called a self-limited one.

2. While cure in a given case can not be affirmed with scientific accuracy, the chances of its being the fact after a certain time under proper treatment are so great that it may be properly claimed to have been effected.

3. Practically, a patient who has been properly treated throughout the active stages of the disease, and who has had no manifestations of its persistence for several years thereafter, may be regarded as cured, and may be told so.

The Unrecognized Chancre: Gottheil: In the International Medical Magazine for October, William S. Gottheil calls attention to the frequent insignificance and fugacity of the syphilitic initial lesion, which leads to its non-recognition in quite a large proportion of cases. Ignorance of its occurrence, and not voluntary falsification, is the cause of the frequent absence of a syphilitic history in undoubtedly specific The author calls attention to the following points of diagnosis:

cases.

1. The presence of a tumor as the original lesion. In its essence, and invariably at the beginning, the chancre is a small round-cell accumulation in the skin or subcutaneous tissue. Ulceration may occur, and usually does, or even phagadenism; but these are accidental, and epiphenomena and almost invariably the specific induration is appreciable at the base of the lesion.

2. The tumor is indolent, painful, and recalcitrant to treatment.

3. A peculiar and characteristic "stony" induration of the nearest lymphatic glands accompanies it, different from the general adenopathy that occurs later as a consequence of the systemic infection. Other lesions, as gummata, do not show it.

4. Chancre runs its full course in a few weeks, while tuberculosis takes months and carcinoma even years for its development.

5. The well-known signs of general luetic infection, osteocopic pain, cephalalgia, synovitis, general lymphadenitis, exanthema, etc., must be carefully and persistently searched for in every suspicious case. They may be so slight as to entirely escape careless examination.

COLEY'S FLUID IN THE TREATMENT OF MALIGNANT GROWTHS.-Wild does not consider that the results hitherto obtained justify the trial of Coley's fluid in any operable case of malignant disease, whether carcinomatous or sarcomatous. A recourse to it only wastes valuable time, and may render subsequent operation impossible. In cases of inoperable carcinoma and epithelioma there is no evidence of any permanent benefit, and the treatment is by no means free from danger. In the absence of any other means of effective treatment a careful trial of Coley's fluid is justifiable in cases of inoperable sarcoma, especially in the more rapidly-growing forms. A limited number of successful cases have been reported in which the disease was of this type, and other cases in which there was temporary improvement. Further researches are desired upon the after-effects produced by erysipelas, as it is by no means certain that the effects produced by the toxines are identical with those which result from an attack of genuine erysipelas.-Manchester Medical Chronical.

THE AMERICAN PRACTITIONER AND NEWS

"NEC TENUI PENNÂ.”

VOL. 33.

MARCH 15, 1902.

No. 6.

H. A. COTTELL, M. D., M. F. COOMES, A. M., M. D., Editors.

A Journal of Medicine and Surgery, published on the first and fifteenth of each month. Price, $2 per year, postage paid.

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FORTY-SEVENTH MEETING OF THE KENTUCKY STATE

MEDICAL SOCIETY.

In this issue will be found the announcement of the forty-seventh annual meeting of the Kentucky State Medical Society, which will be held in the city of Paducah on the 7th, 8th, and 9th of May, 1902. The profession of this State, and all other States for that matter, should remember that we are going to enter upon a new field of action, in so much as the county, State, and national societies will all affiliate, and in order to get into the State or national society a doctor must at least be a member of some local society; that is, if he wishes to join the State Society he must belong to some county medical society, or some similiar organization, and to get into the national association he must be a member of his State Society. We called the attention of our readers to these facts in a former issue of the PRACTITIONER AND NEWS, and we feel that we can not be too earnest in this matter. We have a great State organization-one of the very best in the country-and we ought to be proud of it, and every member of the profession should strive to lend a helping hand in this great work; hence let some one in the counties where there is no society take it on himself to organize a local society. All that is necessary is to meet, select a name, and elect a president, vice-president, secretary, and treasurer, and adopt the