We believe that curetting and cauterizing the lesions only increases the amount of pitting.

The Finsen red light treatment, we believe, has more value than Schamberg and others give it credit. This treatment may readily be carried out by having the windows of red glass, or using red curtains in the sick room.

When involution or decrustation begins a daily olive oil bath aids much in keeping the scabs soft and pliable.

As to diet, this should be liberal and nourishing.

The complications and sequelae are many. They are mostly the results of a severe early toxemia, or of a later secondary infection, and will not be considered at this time.

Dr. Slattery, Lincoln:

DISCUSSION.

I would like to ask Dr. Coats, it is quite an interesting subject to me. I have been city physician in Lincoln for the last four or five years and have observed these cases very closely and I would like to compliment the doctor on this very interesting papaper. I would like to know what per cent of cases respond to vaccination after the diagnosis of smallpox has been made? It often happens in a large family that only one or two of the vaccinations take and occasionally only those two have the smallpox. Of course I am a believer in vaccination in any stage of the case if it is effective and I just want to know what per cent of the cases respond to vaccination?

Dr. Coats:

I would judge that 75 per cent or 80 per cent were influenced favorably by early vaccination even after the diagnosis had been made, and I could illustrate that with a number of cases. I have one in mind, a nurse, who had not been vaccinated since childhood, took one of these cases for me and I vaccinated her the day she took the case and she had an exceedingly bad arm and showed rather severe systemic reaction to the vaccination, but she did not develop smallpox and I laid it entirely to the fact that vaccination when she started in on that case.

Dr. H. L. Wells, West Point:

What per cent of the cases take?

Dr. Coats:

They don't all take. I would imagine that 90 per cent at least. Of. course we don't have the chance to observe thousands of cases, but among us all they do run up into the thousands and I would imagine that 90 per cent took after the early stages had been developed.

Dr. Slattery:

I would like to ask the doctor what his advice would be on keeping the room absolutely dark in conjunction with other practical treatment? Dr. Coats:

Why, I would think it would be beneficial and yet the red light has especial benefit, so it is claimed. I think the darkened room would be preferable and I believe that more often it would prevent pitting, because in the Malphigii the pitting would be likely to occur.

Preservation of Rubber Goods.

Michailovsky discovered that rubber articles may be preserved for long periods by covering them with powdered naphthalin. He sprinkled naphthalin on rubber tubing and placed it in a glass jar. Three years later he found the tubing in perfect condition.

The Use of Camphorated Oil in Suture of Operation Wounds.

Dr. Lampe (Wiener klin. Wochensch., No. 17, 1912), in an article read before the Congress of the German Surgical Society, April 12, recommended the application of camphorated oil before incision and during suture. His procedure is as follows: The skin over the operative field is cleansed with a pledget of cotton soaked in ether and then 2 per cent. sterile camphorated oil is rubbed in thoroughly. After the incision has been made to the desired depth the oil is poured in, any excess being wiped off. The same thing is done at the end of the operation before insertion of the sutures. Under this method of treatment it is claimed that healing takes place with scarcely any disturbance. While camphorated oil has but slight antibacterial properties, it is said to act like Peru balsam by enveloping the bacteria and also induces hyperemia, thereby stimulating resistance to bacterial activity.

New Drug for Carcinoma.

Letulle (Bulletin de L'Académie de Medécine) presents a report concerning a compound of arsenic and phosphorus with albumin prepared by Gnezda and designated as arphoalin. It is a brown, tasteless, insoluble powder, and contains 6.3 milligrammes of arsenic an dabout 6 milligrammes of phosphorus to every gramme of albumin. Applied locally to ulcerated or suppurating tumors it promptly arrests hemorrhage and pus formation and removes odor. Microscopically, Gnezda found that epitheliomatous cells under its influence underwent rapid fatty degeneration, while the stroma soon showed partial necrosis, with gradual healing of the lesion thereafter. Internally, the dose used was 0.25 gramme, an hour after one, two, or even three meals, according to the patient's general condition. Under this treatment rapid necrotic soften

ing of a carcinoma of the neck in a man was noted, as well as healing of a recurrent carcinoma of the left cheek in a woman of eighty-seven years. In the latter case the drug was also applied directly to the ulcer for a month. No further recurrence had been observed two years later.

Fat Absorption.

Bloor (Journal of Biological Chemistry) thinks it is to be generally accepted that, normally, most if not all of the food fat is saponified in the intestine before absorption, and is absorbed as soaps. The question, however, whether all fat must be split before absorption is still in doubt. For the purpose of elucidating the subject, Bloor performed experiments on dogs, using isomannid esters-especially suitable because they possess properties which allow of their being traced through the process of absorption. The results showed conclusively that none of the insomannid esters passed unchanged into the chyle, although digested and absorbed in considerable amount. This, taken in conjunction with the previous findings of Frank, tends to prove that readily saponifiable fatty acid esters do not escape saponification under favorable conditions in the normal intestines.

The Oatmeal Cure in Diabetes.

Dr. S. Strouse has a very interesting review of the recent literature on the above subject, which is an important one (Interstate Medical Journal). He sums up the general views on oatmeal in diabetes as follows: "Practically all investigators who have tested the cure in a thorough manner, agree that it is most beneficial, especially in severe cases where other means have failed to reduce either sugar output or signs of acidosis. Whether this action depends on any inherent quality of the oat starch is still a disputed point. The modus operandi must be considered as yet unexplained; numerous theories have been advanced, but none is supported by actual knowledge. Klotz's researches, if corroborated by other workers, may offer a scientific explanation of the phenomenon.'

Milk and Epidemic Sore Throat.

According to David J. Davis, Chicago (Journal A. M. A., June 15), the epidemic of sore throat in Chicago in the winter of 1911-1912 was caused by an organism belonging to the strep

tococcus group. In the exduates and in the body it was usually encapsulated, but not infrequently in the throat a capsule was not present. It was highly pathogenic for animals, readily producing arthritis in rabbits and occasionally endocarditis. The work of Capps and Miller shows clearly that the infection was largely milk-borne and that an epidemic of mastitis in cows and sore throat in farmers prevailed during the winter in the vicinity of Batavia, Ill., the territory which supplied the contaminated milk. From a typical case of mastitis in a cow from a farm in this region, a streptococcus was obtained pure which was pathogenic to animals, became encapsulated on animal passage and agreed in all essential respects to the human epidemic streptococcus. A cocus identical in morphology, in culture and in pathogenicity was obtained from a human case of tonsilitis and arthritis on the same farm. The relation of these streptococci to the common hemolytic variety, Streptococcus pyogenes, is certainly very close. They may be identical, the differences noted being caused by environmental factors. The fact should be emphasized that streptococci, which cause mastitis in cows, may be pathogenic for animals and virulent to

man.

Tetanus.

Three cases of tetanus, two of them severe, treated by subcutaneous injections of magnesium sulphate solution with recovery, are reported by G. Parker, Peoria, Ill. (Journal A. M. A., June 8). The treatment was suggested by Meltzer and Auer's findings that paralysis could be induced by magnesium salts. There have been reported in the literature twenty-four cases in which magnesium sulphate has been employed by subarachnoid injection, and four in which it has been used subcutaneously. In the subarachnoid cases thirteen patients recovered and eleven died; in the subcutaneous cases all four recovered. Except for a slight bronchorrhea in one patient, an infant, no toxic effects were observed in any of the three cases. There are some dangers, however, from magnesium, chief among which is depres.sion of the cardiac and respiratory centers, and Parker suggests that physostigmin may be used to antagonize such symptoms if they occur. The dosage of magnesium solution recommended for intraspinal injection is 1 c.c. of a 25 per cent solution for every 20 pounds of body weight, but considerably larger doses were employed in these cases reported without ill result.

Treatment of Typhoid Fever by Rectal Injection of Killed Cultures of Eberth's Bacillus.

After proving that the introduction into the large intestine of killed cultures of Eberth's bacillus at 56 C. renders man and animals immune to typhoid it occurred to Dr. Jules Courmont, professor of hygiene in the Faculte de Medecine de Lyon, and to Dr. Rochaix to treat typhoid in the same manner. In a meeting on May 17, they reported the results obtained by this treatment. Of 171 typhoid patients treated in the usual way, twenty died, a mortality of 11.6 per cent. Of thirty-nine patients who received daily until defervescence two injections of 100 c.c. of culture only two died-a mortality of 5 per cent. Moreover, many cases were materially shortened, defervescence occurring prematurely and unexpectedly. Eight patients relapsed, but all were cured.

Action of Strychnine as Modified by Epinephrine.

Mostrom and McGuigan performed experiments bearing on this question in frogs, guinea pigs, and rabbits. They conclude that epinephrine is antagonistic to the paralytic action of strong strychnine solutions on the heart, but that the two drugs have a synergistic action on the spinal cord. Spasms develop more quickly when epinephrine is given with or before strychnine. Strychnine is antagonistic to the general depression produced by epinephrine, but the latter will not antagonize a strychnine spasm. From these findings there is no indication that epinephrine can be applied with benefit in the treatment of strychnine convulsions.-New York Medical Journal.

Boric Acid and Butter.

An experiment has been made by the Food Export Department of Victoria (Australia), which must help to confirm the use of boric acid as preservative in butter. Victorian butter factories were asked to submit four boxes from one churning, to two of which boric acid in the amount permitted by the Australian Commonwealth (0.5 per cent) had been added, while the other two were free from preservatives. One of each was shipped to England while the duplicates were retained in the local cool stores. Cable messages have been received from London that the trade is strongly in favor of the retention of the preservative, and that the butter containing the boric acid has a marked preference of $2 per hundredweight, mainly on the score of flavor.