few drops to a half-teaspoonful, according to circumstances, as directed by the physician." It yields 17.99 per cent of solid matter (including 0.97 per cent of mineral matter) and 18.95 per cent by volume of alcohol. Hemapeptone. This is said, to be a preparation of "albumose-peptone," "the end product of digestion of albumin and hematin, a true organic iron." One is advised to take a teaspoonful, increasing to a tablespoonful as needed, after each meal. Analysis: Alcohol by volume, 10.60 per cent; total solids, 19.54 per cent; mineral matter, 0.37 per cent. Nutritive Liquid Peptone.-This is said to be "a valuable combination containing the nutritive constituents of beef and malt, predigested and ready for assimilation," and to possess "the properties of a gentle and refreshing stimulant." No dose is given. The analysis shows: Alcohol by volume, 14.81 per cent; total solid nutriment, 15.20 per cent; mineral matter, 0.69 per cent. Hemaboloids.-The nutriment in hemaboloids is said to be "partially digested and vitalized by treatment with nuclein, rich in iron and phophorus-producing elements." It is said to enrich the blood, to increase weight and the number of red blood cells, and to enhance nerve action. The preparation is said to consist of vegetable nucleoalbumin, reinforced by beef marrow extract and beef peptones, and is to be used in all impoverished conditions of the blood, such as anemia, general debility and in convalescence from all diseases. The dose recommended is one-half to one tea-spoonful three or four times daily in a little water, plain or aerated, or with cracked ice. "If necessary, increase to two tablespoonfuls." The maximum recommended yields about a quarter of an ounce of nutriment, and the alcoholic equivalent of about an ounce and a half of whisky daily. Analysis shows 6.36 per cent of total solids (about half as much as is contained in milk of fair quality) and 15.81 per cent by volume of alcohol. The mineral matter, which is largely iron, amounts to 0.62 per cent. Tonic Beef.-Tonic Beef is said to contain "the nutritive constituents of beef, wheat and fresh eggs in a soluble, predigested, and, hence, readily absorbable form." One is led to believe that the beef is carefully selected, and that the blending of the constituents of these three very important foods, and their flavoring and aging (whatever that may mean in connection with eggs), have been conducted on most scientific principles. After being treated to an imposing array of facts concerning the value of the preparation, we are informed that "besides being a nutritive, Tonic Beef is a delightful stimulant." Adults are advised to take from half to one tablespoonful every four hours, and at bedtime; infants and children should be given from ten drops to a teaspoonful, according to age. A tablespoonful every four hours will yield to the consumer in the course of a day about a half ounce of nutriment, and the alcoholic equivalent of an ounce of whisky, for analysis shows 15.58 per cent by volume of alcohol, and 18.16 per cent by weight of residue, including 1.04 per cent of mineral matter. Mulford's Predigested Beef.-"A concentrated predigested food containing the entire nutritive value of beef in a completely digested form, ready for immediate absorption. into the system." It is claimed for it that "it is a complete natural food product, containing sufficient nutritive materials to maintain normal nutrition of the body," and that it is "indicated as an exclusive diet in typhoid fever, la grippe, tuberculosis, nervous exhaustion, and all conditions of the system associated with enfeebled digestion and malnutrition." Dose: One to two tablespoonfuls in water every two or three hours, or as needed; children in proportion to age. Analysis shows 19.72 per cent by volume of alcohol, 10.39 per cent by weight of total solids, which yield 0.20 per cent of mineral matter. The maximum administration recommended, that is, two tablespoonfuls every two hours, disregarding the proviso "or as needed," would yield daily about 1.25 oz. of nutriment, and the alcoholic equivalent of about 6 oz. of whisky, which might well be regarded as hardly adequate as an exclusive diet in the diseases above mentioned, or in any other condition of the system.-Boston Medical and Surgical Journal. Oysters and Typhoid Fever. By SAMUEL W. ABBOTT. M. D., Boston. Remlinger reports the results of investigation of 34 cases of typhoid fever received at the French Hospital at Constantinople, from January 15th to June 15, 1902, 17 of which had eaten oysters within the recognized incubation period of the fever. The shores of the Bosphorus abound in oyster beds, very many of which are in regions foully polluted by sewage. As one French writer states: "L'oeil est inutile; le nêz suffit" to distinguish the polluting causes. The oystermen of London have held a meeting2 at which resolutions were adopted calling for measures to be taken to prevent the sale of oysters from beds known to be contaminated with sewage, and also to prevent the discharge into rivers, estuaries, and any part of the seacoast. Dr. Fraser, Medical Officer of Health, of Portsmouth, England, where outbreaks of typhoid fever traceable to oysters have occurred, lays down the following propositions as essential to make out a satisfactory case against the oyster: (1) That the oysters had been eaten at such a date previous to the onset of the disease as would be consistent with what we know as to the time typhoid fever takes to develop in man. (2) That there was no other condition common to all or a large proportion of the cases which could be regarded as playing a causal part in the disease. (3) That the oysters had not only been exposed to sewage contamination, but that this sewage actually contained the specific infection of typhoid fever.-Boston Medical and Surgical Journal. The conditions of the oyster beds in San Francisco are similar to those described by Dr. Abbott, of Boston. We have called the attention of the Health authorities to this condition, and we hope proper precautions may be taken. -[ED.] Rev. d'Hygiene, October, 1902, p. 872. The Cause of Beriberi. Charles Harrington, M. D., Assistant Professor of Hygiene, Harvard Medical School, and Edward F. Willoughby, M. D., London, in the American Journal of the Medical Sciences, publish the following interesting resumé: In a "Discussion on Beriberi" (British Medical Journal, September 20, 1902, p. 830) Patrick Manson calls attention, first, to the importance of coming to an agreement as to the meaning of the term, which, he asserts, has been applied to a variety of other diseases. He believes that even the most experienced practitioners include several distinct forms of neuritis under the one term, and he holds up the history of malaria as a warning, calling attention to the fact that, before the cause of malaria was determined, many types of non-malarial fever were regarded as malarial. Beriberi being a multiple peripheral neuritis, and this condition being the consequence of a number of causes (arsenic, alcohol, ptomaines, etc.), it is not strange that where beriberi exists some confusion must occur. For his belief that beriberi is not arsenical neuritis, he gives a number of reasons, among which is the fact that tobacco, to which arsenic is intentionally added to give it a desired flavor, is not used in institutions, such as jails and schools, in which the disease is prevalent; and, moreover, in the treatment of the disease, arsenic is not uncommonly exhibited and causes no aggravation of the symptoms, which would occur if arsenic were the cause. Furthermore, the skin affections common in arsenical neuritis are not observed in beriberi. He holds that the great majority of cases of so-called malarial neuritis are in reality beriberi, and that the true malarial neuritis is very rare and never epidemic. He believes that beriberi is due to a toxin produced by a germ operating in some culture medium located outside the human body, and that the toxin enters the body neither in food nor in water, but through the skin or lungs. In support of his contention that the cause cannot be a germ living and multiplying in the body, he cites the fact that the most important measure in the treatment of the disease is removal of the patient from the place in which he sickened, which, if accomplished early, and provided the dose has not been overwhelming, is almost invariably followed by recovery. In proof of this statement, the details of a most interesting outbreak are given. The fact that the disease can be introduced into and spread in virgin country is given as proof that its cause is produced by a living germ. It was introduced by the Japanese into the Fiji Islands, by the Annamites into New Caledonia, and by others elsewhere. Thus far all trustworthy investigations have failed to demonstrate the presence of the germ within the human body. That the toxin does not enter the system in food he concluded long ago, by the process of exclusion and on epidemiological grounds. He has no sympathy with the rice theory, and brings forward cogent arguments against it. Proofs that the toxin is not conveyed in drinking water are too numerous to need mention, for it often happens that of two institutions side by side, supplied with the same water, one is the seat of the disease and the other is free from it. He concludes that since the disease is not caused by a germ operating directly in the human body, it cannot be passed as an infection directly from person to person; that being the result of a toxin generated by a germ outside the human body and not conveyed in food or water, it must be conveyed either by the air or through the skin, by contact or by means of some insect which inserts it under the skin, or by a combination of some of these ways; and that, unfortunately, we have nothing to show what the toxin is, nor what the germ is that produces it, nor how it gains access to the body. Captain E. R. Rost disagrees most decidedly with Manson, and believes strongly in the alimentary origin of the disease. He relates that during an outbreak in a jail he observed that pigeons which lived in large numbers under the roofs of the jail buildings were affected by an epidemic disease, characterized by paralysis of the wings, which he attributed to a micrococcus which he found in the rice. Later, in Rangoon, he found in rice-water liquor and in mouldy rice a spore-bearing organism which was extremely resistant to high temperatures, exposure to 220° F. for nine hours being required to kill the spores. He found the same organism in the blood and in the cerebrospinal fluid of a large number of beriberi victims. Cultures |