Professor Hoffa of the University of Berlin delivered a lecture in Germany's section of the Educational Exhibit at the World's Fair in St. Louis, on June 25. The subject of the lecture was Coxa Vera, and it was elaborated by some beautiful specimens and excellent radiographs. About fifty leading St. Louis physicians attended the lecture and a banquet which was given later in honor of Professor Hoffa.

Dr. Elias Potter Lyon of the department of physiology and dean of the medical department of the University of Chicago has resigned his position to become head of the department of physiology in the medical department of St. Louis University.

Anti-spitting Ordinance.-Moline, Ill., has adopted an anti-spitting ordinance, with penalties varying from one to five dollars for its violation. Signs are to be posted to warn the strangers, the careless, and the unwary against inadverently spitting on sidewalks.

Coroner's Fees Inadequate.-The County Officials of Hamilton County, Ohio, have recently gone back from the salary system to the old fee system. This is welcome to most of them, but in the Coroner's office the salaries amounted to $8,100, while the annual fees amount only to about $4,100. The Coroner, Dr. Weaver, is searching the statutes for relief.

The Chicago Hospital.-The Chicago Hospital Building Company, a corporation formed to build the Chicago Hospital at 452 Forty-ninth street, has given a deed of the property to the Chicago Hospital for a consideration of $135,000. The property is located 110 feet east of Cottage Grove avenue, and has a frontage of 75 feet and a depth of 132 feet. The improvement consists of a fivestory brick building. The transfer was made subject to an incumbrance of $30,000, and the grantee has given a trust deed to the Merchants' Loan and Trust Co., to secure an additional loan to John T. Binkley of $40,000 for five years at 5 per

cent.

A New Sanatorium at Denver.-The Agnes Memorial Sanatorium, for the treatment of pulmonary tuberculosis, was opened on July 2, Denver, with fitting exercises. The sanatorium was built and furnished by Lawrence C. Phipps in memory of his mother, Mrs. Agnes Phipps.

The California Vaccination Law.-The Supreme Court of California has reaffirmed the constitutionality of the "act to encourage and provide for a general vaccination in the State." The decision was rendered in a case referred from the county of San Diego, where the antivaccinationists have been creating no little trouble for the school board.

St. John's Hospital Made Free. The board of managers of St. John's Hospital, in Brooklyn, which is under the control of the Church Charity Foundation of the Episcopal Diocese of Long Island, have decided that after July 1, no more pay patients will be admitted to the institution. Hereafter the work is to be of a purely benevolent nature. The number of patients for the present will be limited to the number of endowed beds.

Correspondence.

OUR LONDON LETTER.

(From Our Special Correspondent.)

BIRTHDAY HONORS FASHIONABLE BAZAAR FOR VICTORIA

CHILDREN'S HOSPITAL-HARVEIAN ORATION-RETURN CASES OF DIPHTHERIA AND SCARLET FEVER-POSTOPERATIVE VENTRAL HERNIA-ST. GEORGE'S HOSPITALSLADEN MEMORIAL-OBITUARY.

LONDON, JUNE 24, 1904.

TO-DAY the King's birthday is officially celebrated and a list of honors conferred on the occasion was issued last night. Among them Mr. C. Holman, the zealous treasurer of Epsom College, and Dr. Thos. Stevenson, Home Office Analyst, receive knighthoods. In the order of the Bath Deputy Surgeon-General Thornton, I.M.S., C.B., and Surgeon-General Townsend, C.B., become K.C.B. Surgeon Ligertwood, formerly surgeon Royal Hospita Chelsea, and Surgeon-General Fawcett, Army Medica! Staff, receive the Č.B.

The Queen was present for about an hour at the opening of a grand bazaar at the Albert Hall on Tuesday, in aid of the Victoria Hospital for Children, and subsequently sent a letter to the president, congratulating him on the beautiful appearance of the hall. The sight has been described as "Fairy land in London," the stalls and decorations illustrated nursery rhymes and, of course, the assembly of ladies was most brilliant. On Wednesday Princess Louise, Duchess of Argyle, opened the second day's sale. Yesterday the sale concluded and a grand ball was held in the evening. Over £15,000 was realized. and after all expenses I hear the hospital will receive about £11,000.

The Harveian Oration at the Royal College of Physicians was delivered on Tuesday, by Dr. Richard Caton of Liverpool. He divided his discourse into two parts. The first dealing with Egyptian medicine, in which he gave an account of some of the results which archæological research has arrived at, in reference to the dawn of medical prac tice. About 3500 years B. C., the medicine-god, l-em Hotep, whose name means "he who cometh in peace," was probably a priest of Ra, physician and sun god. From inscriptions and papyri his temples, where healing was carried on, were, in fact, hospitals. The later Greek colonists called them asklepicia. His priests als practised embalming and so acquired definite anatomical ideas. In the Ebers papyrus is a passage which the orator quoted as "wise advice," the importance of which we have, he suggested, scarcely as yet recognized. It was to the effect that in heart disease, if possible, the heart should be made to rest somewhat, and with this I pass by many interesting remarks to the second subject of D Caton's able oration. This was devoted to the prevention of valvular disease. Why do rheumatic joints recover and the endocardium not? asked Dr. Caton, and replied because the joint can rest but the heart cannot intermit its labors. But it may be made to rest partially, and this has been his practice for twenty years. He enjoins absolute quiet, the patient to lie with head at low level. made as comfortable as possible, encouraged to sleep, ne excitement being permitted, and pain or fever being subdued-in short, he seeks to attain the nearest possible approach to physiological rest, as enjoined by our Egyp tian predecessors thousands of years ago. We may add iodides to promote absorption of exudations but chiefly to lower tension, as in aneurysm. Of this plan Dr. Caton spoke most confidently, after carefully following it for over twenty years.

Dr. A. Newsholme read a paper at the Medical-Chirurgical Society on protracted and recrudescent infection in diph theria and scarlet fever. Protracted infection in diphtheria was recognized by Greenhow and Gresswell, but not until recently has it been observed in scarlet fever. It doubtless occurred before the period of isolation hospitals, and Dr. Newsholme would explain by it the persistent belie in the infectiousness of late desquamation. He examined the explanations offered of return cases, which he said were relatively rare, and did not invalidate the value of isolation hospitals. These cases were generally connected with otorrhoea or rhinorrhoea, though in some cases a dorman infection might be roused into activity by catarrh. Gerrs multiplying in the patient himself and collecting on the rhinorrhoeal lesion with which return cases are generally admitted would be more numerous than the lesser number that could obtain ingress from other patients. That increased activity was caused by hospital aggregation was a mere theory borrowed from that of smallpox. In each case it is a theory in support of a theory. Relapses o scarlet fever were compared with those of enteric, and these are not caused by fresh external infection.

At the Gynecological Society, on the 19th inst., Mr Ryall exhibited a giant myoma which had been removed by Mr. Jessett, although a previous attempt at another

hospital had been abandoned. Intravenous transfusion was called for. The patient did well. The tumor weighed twenty-six pounds. Other cases were mentioned by those present-one in which the tumor was over twenty-eight pounds, another twenty-two and one-half pounds.

At the same meeting, Mr. Stanmore Bishop started a discussion on the prevention of post-operative ventral hernia, of which he had had four cases in more than 350 abdominal sections. He urged the necessity of securing firm union of the peritoneum, fascia and skin, as well as the combined tendons of the transversalis and oblique muscles. He discussed also the materials for sutures, their sterilization and preservation, and showed apparatus for securing these objects.

Dr. Macnaughton-Jones said he usually closed the abdominal wall in the manner shown in Mr. Bishop's diagram, which was practically the plan of Noble of Philadelphia, who had lately introduced another method of suture (diagram exhibited). The speaker closed the peritoneum by a fine continuous cumol suture, dissected the fascia from the rectus, and united it by continuous suture passing through the fascia and looping up the muscle at either side, before penetrating the fascia at the opposite side, thus closing the wound by complete adaptation or slight overlapping of the aponeurosis through its entire extent. Any apparently weak points can then be secured by interrupted sutures.

Mr. Charles Ryall said the chief thing was to be sure the aponeurosis was united throughout the length of the wound. The union of muscle would not prevent hernia; that of peritoneum did not add much strength though important in preventing adhesions. Prolonged rest after operation was an important preventive.

Since the almost

Dr. J. J. Macau regretted the absence of those who still used the through-and-through suture. general adoption of suture in layers, subsequent hernia had been less frequent and less severe.

Professor Taylor (president) had found in the postmortem room that union which seemed perfect externally might be incomplete on the peritoneal surface. For some eight or nine years he had united the peritoneum with a continuous suture of the very finest silk sterilized by boiling in a benzine solution. He then passed sutures at about one-half inch intervals through skin, fascia, and muscle without including the peritoneum, but before tying these, he united the fascia for the whole length of the wound, with a close continuous suture of the same fine silk as used for the peritoneum, over which, if desirable, a horsehair suture could be tied and passed through the skin. The interrupted sutures supported the fine ones and after ten days were withdrawn. The silk ones were left. He had seen indications of them two months afterward. In another case, reopened after a year, they had completely disappeared. In only three cases had silk given trouble and they occurred before he used benzine.

Mr. Bishop, in reply, said all agreed that buried sutures should be absorbable. Neither wire nor catgut were; the latter was apt to give way, and if used of the thickness often tried (No. 8) was almost impossible to sterilize; if one could rely on catgut being germ-free the difficulty would be met. By his method it was easy to assure one's self by both sight and touch that the aponeurosis was properly united throughout its entire length.

A special court of the governors of St. George's Hospital was held on Tuesday, to receive the report of the committee appointed in March, 1903, to consider the desirability of removing the hospital to a more extensive site. There was a large attendance, and Lord Windsor presided. The majority of the committee were against removal but there was a minority report. In accordance with the majority, a resolution was moved "that it is not desirable at the present time and under existing circumstances to remove St. George's Hospital from its present site." It was urged that this site was one of the best in the world. On the other hand, it was argued that the hospital is spending at the rate of £10,000 beyond its regular income and a sale of the site would cover that. The resolution was carried. A resolution that the present is not a favorable time to appeal for funds for rebuilding was defeated. Resolutions were carried for utilizing the new site lately acquired for the immediate requirements of the hospital, and authorizing negotiations for the acquirement of additional leaseholds. Just before the close of the meeting a letter was read from Dr. Rob Barnes offering £1,000 toward the expenses of the medical school.

Mrs. Percy Sladen, to perpetuate the memory of her late husband, Mr. Walter Percy Sladen, at one time vicepresident of the Linnean Society, has undertaken to devote the sum of £20,000 to the promotion of research or invesvestigations in natural science, more especially in zoology, geology, and anthropology. Mrs. Sladen has appointed the first trustees of the Percy Sladen Memorial Fundfour in number.

Edward Trimmer is a name appended to thousands of diplomas of the Royal College of Surgeons during the forty-two years he served that corporation as secretary. He retired in 1901. After some months' suffering from malignant disease he has just passed away in his seventyeighth year.

Sir David P. Ross, late Surgeon-General of British Guiana was M.D., Edinburgh, 1863, and M.R.C.S., England, 1864- The same year he entered the army service. Was for twelve or thirteen years in various medical posts in Jamaica; and his subsequent career in the colonial service has been distinguished. In all his varied positions, from a student on ward, he was esteemed by hosts of friends and colleagues.

The death of Mr. A. O. Mackellar, F.R.C.S., Chief Surgeon of the Metropolitan police force and formerly surgeon to St. Thomas' Hospital, occurred on the 15th inst., at the age of fifty-eight. He was M.D. and M.Ch. of the Royal University, Ireland, 1869. He went out to serve as surgeon on the ambulances sent to help in the FrancoPrussian, Turko-Servian, and Russo-Turkish wars, was made Knight of the Military Order of Merit of Bavaria, of the Gold Cross of Takovo, and of the order of the Medjivich.

PARIS. June 10, 1904.

AT the Académie des Sciences, Calmette recently presented the result of his investigations concerning serpent venoms and their antagonistic serums. He differentiated two distinct substances in these venoms, one acting on the blood, the other on the nervous centers. The antitoxic activity of an antivenomous serum is easily determined by experiments in vitro, in which varying amounts of antitoxic serum are made to act on a constant quantity of the defibrinated blood of the horse or of the rat, containing a constant amount of venom. D'Arsonval presented a milliampéremeter intended to measure the inThis tensity of a current circulating in an x-ray tube. method will make it possible to record, rapidly and practically, the strength of the Röntgen rays emitted by a tube.

At the Académie de Médecine, in the session on May 24, Professor Budin made an interesting report on the necessity of breast-feeding for the children of workers in mills and factories. The Academy afterward indorsed this report and forwarded it to the Minister of the Interior. The figures show that among children who die under one year of age nearly half are overcome by diseases of the digestive tract. The great cause of these diseases is artificial feeding; therefore nursing ought to be made possible. The labor organizations should be prevailed upon to permit women to nurse their children. Professor Budin calls to mind the fact that the Italian Parliament enacted a law in 1902 that in all factories occupied by as many as fifty workers there should be a room for nursing. The Academy should, the speaker urged, express the opinion that in all industries and establishments mothers ought to be authorized to absent themselves regularly to nurse their children, and that créches and special rooms should be established near the places for work, where the children could be cared for and nursed.

At the meeting of the Société des Internes et Anciens Internes des Hôpitaux de Paris, held May 26, Dr. Leredde showed two patients with epithelioma of the face, who had been subjected to the action of the Röntgen rays during only five or six exposures of from thirty to forty minutes each. The photographs of these patients, taken before the treatment, showed considerable epitheliomatous masses, situated in one case on the left cheek, in the other on the forehead. The presentation of the patients themselves gave the opportunity of noting the disappearance of the neoplastic masses. Following this presentation, an interesting discussion arose in regard to the action of x-rays on epitheliomata. Cancerous tumors in active proliferation, malignant epitheliomata, seem clearly to be influenced, retarded in growth, and even destroyed by the Röntgen rays. The hard, horny tumors, on the other hand, show no well-marked effect. As to the influence of the Röntgen rays on internal cancerous tumors, this appears to be rather adverse than otherwise. Indeed, Dr. Jacquet cited a case in which the x-rays evidently hastened the death of a patient suffering with inoperable carcinoma of the stomach. Dr. Pechon also cited a case of non-ulcerating sarcoma of the thigh, treated by exposure to x-rays, which was followed by general sarcomatosis and the death of the patient.

Mesureur, director-general of the “Assistance Publique,'' delivered a remarkable address, at the same meeting, on

the social rôle of the "Assistance Publique." He showed how, since the adoption of the altruistic ideas advanced by the French Revolution, the dignity of the indigent patient has been actually safeguarded, and how he has not been considered, as formerly, a dangerous element, and one prejudicial to society. Since the alleviation of misery devolves upon the "Assistance Publique" it ought preeminently to consider its prevention by means of social laws. Laws for the protection of the woman and the child give, from this point of view, an immediate and certain return, for in safeguarding their health and their capability for work, both the woman who is to be the mother and the child who is to be the citizen and the soldier of the future are protected.

A great project, the most important, perhaps, which would considerably lessen the debt of the 'Assistance Publique," is that which relates to the relief of the aged and incapacitated workers, and to the provision of homes for the superannuated. Thus Society, diminishing little by little the causes of misery, establishing the right of the individual to the consideration of humanity, will finally cancel its debt to humanity. And yet, no laws can wholly do away with misery and illness, for there will always remain some who are starving and some who are ill. The "Assistance Publique” is indeed at hand, as an automatic instrument, to distribute succor, to relieve the hunger of a day, but never, by itself, will it raise up again a being who has fallen. To its official efforts must be added the disinterested help of private individuals who will give that useful counsel, that moral support, which will reawaken dormant energy, will arouse the power for work, and will give assurance for the future.

It is in the hospital that the divers forces of this charity can unite. The patients, in effect, in coming to the hospital, largely pay their social debt by constituting the vast field where science reaps its harvests, where all the youths of our scientific schools find the essential material for their studies. Passive and apathetic, the patients contribute their part to the progress which has made the renown of the French medical schoo so wide spread. The "Assistance Publique" considers that its honor lies not only in the fact that its hospitals afford an asylum for those who suffer, but also in the fact that they constitute a great practical school in which the country may take pride. It demands that the physician love these who so generously offer their sufferings as a means of instruction, love them in order to cure them, and also that he recognize in the patient a human being whom a word can console. It demands that these guardians of science, these intellectual giants, who have dedicated their great powers to the cause of healing, shall endeavor, by arousing a greater sympathy among men, to create a better society, with less of suffering and more of justice.

At the Society of Surgery, the question of intermittent hydronephrosis, of which we spoke in our last letter to the MEDICAL RECORD, was again discussed. Dr. Guinard then reported a case of poisoning by camphor-naphthol, in which a man succumbed a few minutes after its injection into the cavity of an abscess from which the pus had just been evacuated. Kirmisson also cited cases in which camphor-naphthol injections had produced untoward accidents. The symptoms always take the same form, that is, either syncope or epileptiform attacks. Guinard stated as conclusion of his communication and of the discussion which followed, that it seemed to him the administration of camphor-naphthol by this method should be discontinued.

Among the serious losses which the scientific world has recently experienced we would mention the death of Professor Marey, member of the Academy of Medicine and of the Academy of Sciences, whose works on experimental physiology are well known. The sphygmograph and the cardiograph of Marey are instruments too widely distributed, too generally adopted throughout the world, and of a usage too common, for it to be necessary to lay stress on the great discoveries of this savant. During more than forty years, indeed, Marey devoted himself to the difficult problems of the heart and the blood-vessels. His great work was the development of the graphic method, that is to say, the direct inscription through the medium of pens of the biological phenomena observed. By a series of photographs Marey was able to study and to recognize all the phases of the circulation of the blood in men and in animals. Moreover, he made an interesting and valuable study of the flight of birds and of the various movements of their wings.

Health Board Changes.-Commissioner Darlington has again shifted the assistant sanitary inspectors. Dr. Moore, who was sent from Queens to Richmond, two weeks ago, goes back to Queens; Dr. Sprague, who was sent from Richmond to the Bronx, comes to Manhattan; Dr. Murray, who went from Brooklyn to Queens, goes to Richmond. Dr. Pursall, who went from Manhattan to Brooklyn, will remain there one week longer.

OUR BERLIN LETTER.

(From Our Special Correspondent.)

QUINQUAUD'S DISEASE-BERLIN LIFE-SAVING SOCIETY-ECLAMPSIA AND THE NERVOUS SYSTEM-INFANT MORTALITY-FIRST REPORT OF MEDICAL SCHOOL INBERLIN, June 4, 1904.

SPECTORS.

Ar the meeting of the Society for General Medicine, held May 16, Fürbringe delivered an address concerning the value of Quinquaud's sign. The inquiries of many physi cians had caused the speaker to give closer attention than before to the nature of this sign. Speaking of its history, he told how a teacher by the name of Quinquaud, as Maridon made known in 1900, made the following experiment with his scholars in 1893: He had them place the finger tips of a patient against the palm of his hand, and held them there a few minutes. Among the students several were evidently scornful. In a little while crepitation was apparent in the phalangeal joints of the fingers that had been placed in position. This phenomenon can be observed only in the case of drinkers, and then not with moderate drinkers. The degree, therefore, to which alcohol has been misused can be judged by the strength of the crepitation. Fürbringe examined in this way five hundred patients, drawing them from both the hospital and his own private practice. He divided those whom he examined into four groups: almost total abstainers, moderate drinkers, drinkers, and drunkards. He divided the sounds observed into three groups: perceptible, moderate, and strong. In the case of the drinkers, he found it sufficient if they placed two fingers only in position, the two chosen being the ring and the middle finger. He prepared the following table:

It is evident from these tables that one can recognize a drunkard with greater certainty by tremor than by Quinquaud's sign. It is to be noticed that neurasthenia and hysteria influence both these phenomena. In no case was there any change in the joints. The phenome non ceases when the subject is tired, but reappears after a short time. Fürbringe drew the conclusion that Quinquaud's sign should not be taken alone in making the diagnosis of alcoholism, but it is of value in connection with other symptoms.

The recently published report for 1903 of the Berlin Life-saving Society gives the opportunity for a few general remarks concerning the present situation and the outlook. In the case of street accident or sudden illness in a house, the sufferer heretofore would receive help first from the stations established by the Red Cross Society. There are twenty of these stations in Berlin with their directors and assistant physicians, who, it is said, know how to make a very good practice for them selves from the patients who come to the station, and have made inroads upon the practice of the physicians of the district. In spite of this, the number of stations established was not increased according to the demand. Seven years ago the Berlin Life-saving Society was founded by Morris von Bergmann, and this society at the present day has fifteen head stations, chiefly in the cities and in connection with the royal hospital, and also tes relief stations. In the latter, each physician of the district is on duty from two to four hours every week Care is taken that one in laying claim to the help of a station does it but once in the course of an illness. The Life-saving Society is doing a very great work through the introduction of a central station for the care and attendance of the sick of Berlin, concerning the great social and humanitarian significance of which movement we shall speak later. According to the yearly report, 6,074 cases were treated in the chief stations, and 10,946 in the relief stations. The increase since last year has been remarkable. A year ago union with the accident stations was refused by the Life-saving Society, but on April 19, 1903, a common agreement for first aid was es tablished.

An interesting discussion took place at the meeting of the Obstetrical and Gynecological Society. It had to do with the still unsolved problem of the cause of eclamp Bruno Wolf had repeated the well-known exper ments of Blumenreich on animals, in which he removed

sia.

both kidneys from a large number of rabbits, some being pregnant, and some not. He made the following important deductions: (1) In the case of a pregnant animal, both of whose kidneys have been removed, the foetus dies before the appearance of any uræmic symptoms in the mother. (2) Typical uræmic attacks, with convulsions, occur very seldom after the operationtwice out of seventy-four cases. Blumenreich believed that Wolf had overlooked the convulsions because they affect, for the most part, chiefly the neck muscles. Olshausen reported a case in which he, in spite of cutting off the action of the kidneys known to be failing had seen no convulsions. For this reason it was plain that the poison of eclampsia is something different from the uræmic poison due to extirpation of the kidneys. Machenrodt had seen a similar case, and Olshausen instanced the fact that in the end stages of carcinoma which causes suppression, uræmia has been observed, but not convulsions.

For the past week there has been summer weather in Berlin, and already the waiting rooms of physicians, especially of those in the working districts, are full of children. The mortality among infants has increased greatly. At the beginning of last month, much light was thrown on this question at a meeting of the newly-formed society for combating the death rate of infants. Professor Hubner held, in this discussion, that, as a result of the falling off of nursing in Berlin in 1898, the mortality of infants had increased-and that solely because of a lack of patience and will power on the part of the mothers. While out of 1,000 living of the general population 18 die, out of 1,000 living infants 286 die. Since in the Strahlauer Foundling Asylum out of 1,000 children only 40 die, an effort to diminish the death rate of children seems wise. As a return to breast-feeding will take some time, the thing to do now is to improve the cow's milk. Ostertag briefly stated the question from the pathological point of view. The milk from diseased cows is capable of transmitting typhoid fever and tuberculosis, and may become poisonous from diseased udders, and also from medicines or food poisons contained in the milk. The milk of healthy cows may be poisonous when the milking is not done in a sanitary manner, or when the milk is not kept cool, for the bacilli which cause milk to sour are not killed by heat. Concerning the regulation of the milk supply, Engel made the statement that in Berlin over 2,000 children were injured by cheap milk. Through the action of the society many dairy companies have agreed to have their cows, stalls, etc., inspected by veterinarians and physicians. The director of railroads has been asked to have refrigerator cars for transporting the milk. Further action of the society has brought about the following: (1) Copies of regulations will be sent to dairies, physicians, infants' and children's asylums. (2) Midwives will be instructed in regard to the value of breast-feeding. (3) Notices from the society will be sent weekly to the mothers of the new-born, with a list of the inspected dairies, and with instructions regarding the care of milk and the feeding of infants. (4) A relief fund is to be established: (a) for poor mothers, so that by better nourishment for them, better nourishment may be assured for the children; (b) in order that poor people may be able to buy better cow's milk; (c) for providing for the destruction of the milk of diseased cows, after imposing a fine upon the dairy. (5) An agreement is to be entered into with other societies pursuing similar courses, and as many coopertors as possible won in distant places.

How necessary the improvement in the nourishment of children is, was shown by a recent report concerning the work of the Berlin school physicians, appointed in the spring of the present year. Ffteen thousand children, recently entered in school, were examined by thirty-six physicians. Ten per cent. of all the children were found to be physically or mentally unfit, and excused from school attendance for from one-half to one year. Of these, 25 per cent. suffered from general physical debility, 16 per cent. had not overcome the results of the sicknesses of childhood, 5 per cent. had tuberculosis, 15 per cent. suffered from anæmia, scrofula, or rachitis, 10 per cent. were undeveloped mentally.

A GARDEN PARTY GIVEN BY DR. LORENZ TO AMERICAN STUDENTS IN VIENNA. (From an Occasional Correspondent of the MEDICAL RECORD.)

Two weeks ago the Anglo-American Medical Association of Vienna-composed chiefly of American physicians who are studying in the various clinics in this Mecca of medical pilgrims-invited Prof. Dr. Adolph Lorenz to dine at the association headquarters and after the dinner give a lecture upon any subject he should elect. Dr. Lorenz accepted the invitation, and gave a lecture on Coxitis and his method of treatment. Following the lecture he spoke at

length of his reception in America by the profession, and of the warm hospitality tendered him wherever he went while there. He next spoke of his-heretofore-inability to return any of that hospitality, and he took this opportunity of extending to the members of the association an invitation to come to his summer home, overlooking the beautiful blue Danube, and attend a garden party, the association being privileged to set the date which would best conform to their convenience. The association acted at once upon the invitation and voted then and there to accept the generosity of Dr. Lorenz, and Friday, June 24, was set as the date.

The weather was perfect, cool and pleasant, an ideal June day, the members of the association and their wives met at Alserstrasse station in time for the afternoon train which was to take them to Greifenstein-Altenberg, Dr. Lorenz having insisted upon bearing every expense of the trip for each of his guests. We reached Attenberg about 5:30, and were met at the railway station by the genial doctor, who greeted every one individually in the most gracious manner, then piloted us up a woody mountain road in the delicious coolness and fragrance of the shade and odors of the flowers and shrubs, to an opening commanding a most extensive view of the Danube and its valley for many miles, and of the most glorious country imaginable, mountains in every direction, many of them surrounded by picturesque old castles, and everywhere winding in and out, 'like a blue ribbon,' "the lovely

Danube.

The rare beauty of the scene cannot be expressed in mere words. It burst upon our view so unexpectedly that we were spell-bound for several moments. Soon, however, our spell was broken, for as we moved on a little further we were greeted in the warmest and heartiest manner by Madam Lorenz, wife of our noted host, who with her sisters had arranged a booth, under a huge umbrella floating from the top of which were seen the stars and stripes of our own loved country together with the orange and black of Austria. Music was also there, furnished by a company of Vienna musicians. We were invited to seat ourselves upon the grass to rest and enjoy the beauties around us, while we were served with tea, coffee, seltzer and white wine, beer, cake, and cherries. And such cherries! One could not find in any land more perfect fruit and more varieties. When we had enjoyed this pleasant refreshing for a time we were invited to continue our walk a little further, through lovely acres of currants, gooseberries and cherries, on down to the beautiful villa of Dr. Lorenz, which nestled about half-way down the mountain. Dr. Lorenz seemed to be everywhere, first in the fore-front, then in the rear and all along the line, and 'twas a long line, as we marched in "geese-walk" as the doctor expressed it (Gänse Marsch) about eighty of us-to his home.

It would be impossible to imagine a more cordial welcome than was accorded us, as time and again our delightful host urged us to "be at home, "be at home."

The villa consists of an original or old part and a very handsome new part. The stones of this new part have come entirely from old and noted Vienna buildings which for one reason or another have had to be taken down, and Dr. Lorenz bought them and had them transferred to his country seat, and when sufficient had been collected in this way he had the beautiful new part of his dwelling put up. The balustrade surrounding the wall and grounds came from an old stone bridge which crossed the Danube near Vienna at one time.

The ladies were taken into the private rooms of the house to remove their wraps, smooth out the wrinkles, and shake off a little of the railway dust, then went out to assemble in the palatial hall, while the doctor with the professional men ascended the stairs. The guests finding places in the beautiful gallery overlooking the hall, Dr. Lorenz stepped forward into a little balcony and addressed his guests in the warmest words of greeting and welcome. He welcomed the wives of the physicians, whom he considered as representing that type of American woman, who, as doctors' wives, shared the hardships of a doctor's life. He "welcomed the two lady doctors, whom he considered as that type of American woman who stood for woman's emancipation, and he welcomed the lady who, as neither doctor nor doctor's wife, was known the world over, and who had done so much for the profession" -Mrs. Armour-who had come out to join the Americans in their pleasant treat at his home.

He spoke again of his appreciation of all the American hospitality which he had received, and said that it gave him great pleasure to welcome us as his guests. Dr. E. L. Swift, of the United States Army, responded to the word of welcome in a very pleasing manner. After this Dr. Lorenz escorted us through his house, showing us the various apartments, the beautiful paintings from the brushes of the old masters; pointing out to us, here and there, some object of special interest. We were even

The house is truly beautiful. From every window one found the most glorious views of the surrounding country, while within the arrangement of the house, its furnishings and hangings, proclaimed the exquisite taste and appreciation of the harmony of color of the host and hostess.

The sixteen-months old son of Dr. Lorenz claimed considerable attention-a beautiful blue-eyed boy, strongly resembling his noted father, the perfect picture of health and happy disposition.

We were now ushered out to enjoy the beautiful grounds surrounding the house, and a little later escorted to the tennis court, which was most perfect if its kind. Here we found many tables spread with snowy linen and shining silver and flowers in profusion arranged about each place in a most artistic manner. Overhead were strung

our meal.

dozens of very pretty Japanese lanterns. At one side of the court was the dais upon which were seated the Viennese musicians who made music for us during the afternoon. They played and sang many very pretty selections during The supper was served in the most attractive, dainty manner, and consisted of the most tempting, delicious food one could wish for. Here again our interesting host and his good Frau flitted here, there, everywhere, among their guests, looking after each one's comfort and appetite in a manner delightful to see. Nothing was left undone that could in any way add to the pleasure and content of each and every guest. After the meal the musicians played America, whereupon we all arose and sang the national hymn right lustily. This was followed by the "Wacht am Rhein" and the Austrian national hymn. Professor Lorenz at this juncture presented each guest with a souvenir post-carte upon which was a picture of his villa, and for those who desired it, both he and his wife added their signatures.

The tables were pushed to one side and the musicians began to play dance music in such an inviting manner that the toes of the younger members of the profession could not resist, and soon the scene changed to one of frolic and fun, which lasted until about ten o'clock, when the doctor's carriages drove up prepared to take the ladies to the railway station, a short distance away, and the delightful "garden party" disbanded.

The event was certainly one in a lifetime, an afternoon and evening never to be forgotten by those of America's medical profession who were privileged to enjoy it.

The following physicians were present: W. M. Engelbach. G. A. Gardener, F. G. Harris. J. L. Jacques, O. H. Kraft, W. H. Lamborn, G. P. Marquis, F. R. Morton, Brown Pusey, G. W. Parker, H. Schafer, and J. I Wernham, of Illinois; A. E. Austin, D. W. Clark, F. J Hurley, D. J. McSweeney, A E. St. Clair, of Massachusetts; H L. Aller, F. Goldfrank, Mary Sutton Macy. Isabelle Thompson Smart, A. W. Booth, of New York; E. S. Geist, D. N. Lando, H L. Williams, of Minnesota; Francis W. Alter, H. W. Ely, H. H. Wiggers, Tubman, of Ohio; H. L. Akin, E C. Henry, S. J. Jones, of Nebraska; A. L. Mackenzie, E. A. Mallon, H. G. Wertheimer, of Pennsylvania; E. D. Clark, F. N. Hibben, of Indiana; Louis Rassieur, F. L. Stüver, of Missouri; E. D. Chipman, Chas. Fitzgerald, of Connecticut; E. F. Dodds, L. H. Fligman, of Montana; H. J. Schlageter, A. S. J. Smith, of California; J. J. Sullivan, New Jersey; E. Van Hood, Florida; S. K. Simon, Louisi ana; C. E. Zerfing, South Dakota; Bernard J. O'Conner, Kentucky; A. C. Behle, Utah; R. P. Daniells, Wisconsin; R. H. Dean, Iowa; J. H. Davis, Colorado; A. W. Ives, Michigan; C. A. Lilly, Kansas; Walter Luttrell, District of Columbia; E. L. Swift, United States Army; A. H. Bennett, Adelaide, Australia; W. H. Goodden, Bristol, England; A. S. Wilson, Aberdeen, Scotland.

PHTHISIOPHOBIA.

TO THE EDITOR OF THE MEDICAL RECORD:

SIR: I have only lately read the very able plea for "Justice to the Consumptive" made by Dr. S. A. Knopf in your issue of January 2. In quoting me as opposed to the Goodsell-Bedell law, I am sorry to confess that Dr. Knopf does me too much credit. My opposition to this bill was solely on account of some details that seemed to me to make its operation impracticable. I am the rankest kind of a phthisiophobe, though no longer of an age or build to have any personal fear of the disease. Statistics show that, excluding deaths from violence and old age, tuberculosis kills about a quarter of us all, hence its control has just about one-third of the importance of all other diseases together. A parasitic disease which has no necessary intermediate host, which requires no peculiar method of implantation, and which is not semelincident, can, according to our present knowl

edge, be controlled satisfactorily only by the general principles of quarantine.

It is straining at a gnat and swallowing a camel to subject patients with acute exanthematous diseaseswhich are all semelincident-to the hardships of quarantine and to allow tuberculosis patients, in the stage of discharge, to go free. I believe that whatever diminu tion in the prevalence of tuberculosis has thus far occurred, has been due mainly to professional and lay phthisiophobia, and not to any considerable degree to condemnation of cattle, improvement of resisting powers, or therapeutic measures against the existing disease. I believe, also, that just as leprosy was removed from most European countries in the middle ages by enforced segregation, so enforced governmental segregation in sanatoria is the only promising method of dealing with the modern problem of tuberculosis.

With regard to the exclusion of tuberculous immigrants, I agree with the Surgeon-General of the U. S. Public Health and Marine Hospital Service that no immigrant should be admitted who is any way a menace to our own country. Indeed, I would go much further, and admit only a very superior class of prospective citizens. In other words, when the matter concerns the general welfare of my countrymen, I would be absolutely cold-blooded and selfish.

A. L. BENEDICT, MD.

156 WEST CHIPPEWA STREET, BUFFALO, N. Y.

INFECTIOUS DISEASES IN PERU.
(From Our Special Correspondent.)

AREQUIPA, May 31, 1904. THE bubonic plague seems to have taken a permanent hold of Lima and Antofagasta. It is probable that from these centers it will extend to the rest of the coast. In Lima the cases are not numerous and are of a comparatively mild character, many of those attacked recovering and the infectivity being low.

Here we are having smallpox and a few cases of dipbtheria. The former, when treated early by touching the papules with carbolic acid and also giving the same remedy or salol internally, generally doing well and leaving little disfigurement.

Diphtheria, if treated early by antitoxin and a mixture of tincture of chlorate of iron, solution of ammonium acetate and potassium chlorate taken in lemonade, and the throat swabbed out with peroxide of hydrogen and glycerin, is not very fatal. The infection of diphtheria may last for a long time.

I saw in consultation this month a boy of eight years suffering from diphtheria. More than two and a half years previously I had seen his aunt with diphtheria n the same house. There was no other known or suspected source of infection. The house had been shut up after the illness of the aunt.

Progress of Medical Science.

The Boston Medical and Surgical Journal, July 7, 1904. with Aciduria (Acetonuria) Associated Death after Anæsthesia.-E. G. Brackett, T. S. Stone, and H. C Low report a number of cases which present certain features in common: Vomiting associated with collapse. a very weak and rapid pulse; an absence of fever unti just before death; cyanosis in the fatal cases causing extreme dyspnoea; apathy and stupor alternating with periods of restlessness at first, but in the fatal cases gradually deepening into coma and death; and the presenc of acetona in the breath and urine. In six cases the symp toms came on without operation. In three of thes cases the symptoms came on the day after entrance, ar in one two days after. In one case the symptoms came on after the child had been in the ward for four weeks and was up and about. In seven cases the symptoms followed operation. Three of these patients died, fr recovered. In the four milder cases the symptoms camon between 12 and 24 hours afterward. In the thre fatal cases, alarming symptoms came on after about 12 hours, but in none of the cases was the recovery in the operation quite normal. Those children in whom il symptoms were severe were of high-strung, nervous temperament. The symptoms coming on after opera")" were usually more severe than those coming on without operation, although there was one rapidly fatal case the latter group. Death in the fatal cases occurred in r 12 to 36 hours after the onset of the symptoms. It sect. to be due in some cases to a lack of oxygen. Eleva cases showed acetonuria, and only two did not show cetic acid in the urine, and in one of these the test was made for it. The only marked anatomical lesion fouri in the four autopsies was the extreme fatty degeneration of the liver and the muscles. From the study of thes