troublesome disease. It is palatable and efficient in the doses named, a tablespoonful after each meal and at bedtime being the usual quantity required for successful results.

SUMMER COMPLAINT.

BY FRANK J. ROHMER, M.D.

KILN, MISS.

IN the discharge of our professional obligations, I know of no ill that is approached with more of that sense of responsibility and apprehension than those disorders incidental to the first and second summers of childhood, which are especially marked in bottle-fed children; improperly fed would no doubt be the right term. This may mean over-feeding, impure feeding, or insufficient feeding.

The treatment of gastro-intestinal diseases in the young should, in my opinion, be classed into three divisions — viz., antiseptic, tonic and evacuant. First of all, the child must be put under the very best of hygienic treatment. Filtered or boiled water, pure air and out-door exercise in the sunshine are important factors in the welfare of the little one. Water should be used freely, and should never be withheld from a dry, parched and burning throat. Be a radical hydropath. Inject slowly into the bowels of the young patient a half to a quart of tepid water. I know of rothing better than rice water, with the addition of some mild antiseptic; listerin has proved very beneficial, in two to five tablespoonfuls to the quart of clear rice water. A tepid bath several times a day would be indicated. Feeding would play an important rôle; it would be best at times to withhold food, as the alimentary tract being in an altered condition, assimilation is delayed or else prevented.

Cholera infantum, as we understand it, is characterized by sudden muscular debility, spasmodic griping, pains in the bowels, watery evacuations, obstinate vomiting, dampness and coldness of the entire body, pale and livid lips and tongue, associated with cold breath and feeble pulse; collapse is more or less complete.

F

The first thing to do in the way of treatment is to administer something to arrest the vomiting and purging, for which, after administering the rice water and listerin for irrigation, I would give the following: R Bismuth subnit., 3 iss; lis terin, 3 ss; glycerin, 3 iss; mistura cretæ, q.s., 3 iiss. M. Sig.: A tablespoonful every two hours. This, with frequent irrigations of listerin and external applications of tepid water, will be of some benefit, if the patient is seen in time.

If the child is suffering and irritable, not finding relief from applications, I would give some form of opium, such as the camphorated tincture. Small doses of hyoscyamus and chloroform, with glycerin, seem to quiet and arrest the progress of the disease.

MALARIAL HEMATURIA, OR HEMOGLOBINURIA.

BY ELISHA W. BREAZEALE,
BERMUDA, LA.

Student of Medicine, Memphis Hospital Medical College.

WITHOUT attempting to enter into the history of the plasmodium malariæ, nor to discuss for one moment its etiology, nor trace the microorganism through its various stagessporulation, segmentation, method of attack upon the red blood corpuscles, rupture and destruction of these corpusclesbut taking it for granted my readers are thoroughly familiar with the work of such men as A. Laveran, Ed. Klebs, A. Celli, Golgi Canalis, Patrick Manson and a host of others, I shall attempt to reason with them as regards the manifestations of malarial toxemia as exhibited in hemoglobinuria.

The researches of the present day have shown, beyond a doubt, that there is a distinct, a material difference between bacilli and the toxic material as generated by these bacilli, whether it be that of diphtheria, scarlatina, tuberculosis, variola, tetanus, glanders, cholera, typhoid fever, anthrax, pneumonia or others. It is not the microorganism per se that stupefies the individual, that paralyzes the nervous mechanism or produces its various other manifestations, but the toxic material, toxomucin or substance thrown off by the germ. We realize this in all diseases of bacterial origin.

The immortal Jenner was the first and foremost to throw the banner of this reasoning to the breeze, little knowing at the time that he was opening a door of thought and research along the lines of which toxins have been appreciated and antitoxin measures devised. Bacilli in themselves produce no trouble, but it is against the toxins they generate that our attacks are made. We administer diphtheritic antitoxin, not to destroy the diphtheritic bacillus, but to neutralize the toxin as evolved from this bacilli, and dame nature does the rest.

In the absence of the discovery of a neutralizing principle for the toxin as generated by the malarial parasite, we should bear in mind that the human body is capable of evolving a remedy for every disease that human flesh is heir to, and endeavors to use these remedies whenever occasion requires it. There is a law laid down by the great Architect of the Universe that all animate and inanimate things have a constant cycle. This holds good with the material as well as the immaterial surroundings of our beings; whether applied to the planetary bodies in their constant and uniform revolutions or to the infusoria, the minutest form of conceivable animal life. This law may be warped, may be deviated by the hands and minds of men, but above and through it all the true principle shines forth. Production of animal forms is but the multiplication of cell life. Each microbe, each bacillus, each protozoon, each animal has its cycle to perform, as manifested by its birth, life, reproduction, death and decay. Each genus as a whole has its cycle to perform, i. e., existence, multiplication, degeneration, decay and disappearance.

Thus the plasmodium malariæ, as generated from nature's laboratory in that soil suitable for its development—heat, moisture and decaying vegetable matter-finds lodgment in the circulating fluid of the human being, either through the medium of respiration or by inoculation by the mosquito of the genus anopheles; these germs multiply and decay. At each cycle there is a toxin evolved; this toxic material nature is fully capable of taking care of no disaster results to the individual. A shock to the nervous system, chill; a stimulation of the heat producing centers, fever; a subsidence, a

feeling of well being. Here is where we behold nature's divine law, the birth, development, rise, zenith, decline and decay of every colony, every nation, every genus or organized structure, for without treatment these protozoa soon run their allotted time and disappear. The administration of quinin or other antiperiodic measures shortens the cycles of these malarial germs, and thus the remedy is surely indicated. But when from perverted function or the inability of the individual's organism to take care of the toxin generated, it accumulates in the circulating system, an acid reaction occurs; this acid by its chemical effects on the hemoglobin of the blood produces a degeneration of the red blood corpuscles, a surcharging of the blood plasma with hematin and the toxin of the protozoa. Nature comes to the rescue and endeavors to drain the system through the medium of the kidneys—hemoglobinuria.

That the malarial parasite is a progeny of the soil is proven. by recorded observations and research. That the human being is not the only medium for their development is also an accepted fact. Tyson, in his deductions from Patrick Manson, says: "Both types of sporulating plasmodium possess the same function-the propagation of the parasite-one in the human body, the other outside of it."

I purposely leave out of consideration remittent, pernicious (algid and congestive), chronic and irregular forms of malarial fevers, feeling confident the most casual observer perceives the radical difference here and that of the disease under discussion, in which types the malarial microorganism is present performing that cycle which is inherent to all organized structure, held in check, preventing their destroying themselves by the protecting influence of nature's remedies, neutralizing the toxin.

The toxin not only produces the acidity of the blood, but is inimical to the life of the germs themselves, and they die rapidly. Bacteriological research has shown that within ten hours from the onslaught of a case of hemoglobinuria no malarial germs are found in the blood, and that fresh protozoons placed in the blood drawn from a patient thus attacked die within eight hours, showing conclusively they could not

live in this toxic medium generated by themselves. This statement can readily be appreciated when we take into consideration the prognosis of all self-limited infectious diseases, to which class malarial hemoglobinuria undoubtedly belongs. All diseases of the above class culminate by the death or destruction of the microorganisms causing the respective disThis destruction being produced by the toxin generated, or the gradual termination of the inherent life of the bacilli, by that underlying cause which permeates nature and is applied to all forms of life from the lowest and simplest of construction to the most complex of organized beings.

ease.

To give quinin then when there is no germ to kill is not only useless but suicidal. Quinin is a cardiac depressant, a diminisher of reflex action, arresting the movements of the white blood corpuscles and an irritant to the already congested kidneys. This irritation of the parenchymatous structure of the kidney produces further congestion, hyperemia, stagnation of the white blood corpuscles in the uriniferous tubules, a coagulation, a plugging, a cessation of urinary secretion, thus nature's channel of elimination is cut off. Meanwhile a similar condition prevails in the liver-a stupefied, poisoned and congested organ. A dusky, icterous color is imparted to the skin through the efforts of that organ to assist the kidneys and liver. A damming back into the circulation of not only the toxin of the protozoa but the urea of the disintegrated red blood corpuscles as well as other excrementitious principles. Paralysis of the cerebral centers ensues, destruction of the coördinating powers situated in the cerebellum, death to the reflex nervous actions, a stupefied heart, and a swift and speedy passage of the immortal soul to the realms of oblivion. Then what must we do?

Delve down into the depths of research and produce for malarial toxemia what has been produced for other infectious diseases-an antitoxin. And until we do this we can only follow that treatment which reason and common sense dictate. Throw out a life-line, bridge the patient over, and instead of further poisoning his already poisoned body by the administration of quinin, obstructing nature, as it were, assist her in the elimination of the toxic materials, and give the dis