a punishment from God, and as such unpreventable. That the latter can be done without destroying religious faith is shown in the United States, where there is no conflict between rational medicine and Catholicism. For this reason the establishment of American bishops and the introduction of American priests, who can be counted on to throw their influence in favor of modern medicine and sanitation, is bound to be a factor of the first importance in the sanitary regeneration of the Philippine peoples.

OUR LETTER FROM NEW ZEALAND.
(From Our Special Correspondent.)
ANTHRAX-SMALLPOX-ANGLO-SAXON "CONSERVATISM
CURABILITY OF LEPROSY

AUKLAND, N. Z., November 12, 1903. SINCE I last wrote anthrax has made its appearance in New Zealand. Several cases have occurred in the rural districts, one of which has been brought up to the Auckland Hospital. I had, through the courtesy of Superintending Medical Officer Dr. J. C. Collins, the opportunity of seeing a number of beautiful preparations of the anthrax bacillus obtained originally from the patient, from cultures of the bacillus, and from the blood, liver, and kidneys of hice poisoned by inoculations from the pure cultures. Dr. Collins is an enthusiastic bacteriologist. It is believed that the disease originates from bone-dust imported from India, which is brought here in large quantities. It was supposed to have been properly sterilized before export, but evidently some carelessness has been shown in the process. Very energetic measures have been taken by the Agricultural and Health Departments to stamp out the disease, and sterilizing stations are being erected by the Government at the chief importing ports.

The smallpox scare has passed away. This disease, which really seemed to have obtained a firm footing in Tasmania, has now entirely disappeared. It must be from some quality in the air, unfavorable to the spread of the disease, for it certainly is not from vaccination, which is most imperfectly performed all over Australasia. It is curious how long the prejudice against vaccination lingers. The diseases which, in rare instances, were propagated by inoculation from diseased vaccinifers, cannot be produced now that calf-lymph is used, and human vaccine, absolutely prohibited. Yet we find the antivaccinators as furious as ever. Quare fremuerunt gentes?

We are expecting a visit from Dowie very shortly. We know him of old. He was here some eighteen years ago. He is certainly a very powerful hypnotizer, and it is by hypnotic suggestion that he effects his cures. I was employed by one of the principal New Zealand dailies to investigate his cures. I found none that could not be explained by hypnotism. But then hypnotism has a much wider range than most of our English-speaking physicians dream of. It is much to be regretted that so few-so very few-ever study the action of hypnotism as the French and Germans do. However, this is one of those subjects about which it is useless to write and equally useless to speak. The typical "Anglo-Saxon," as he delights to call himself, whether he dwells in America or in England, is the stupidest human animal to be found in the world. I have had considerable practical experience of negroes, natives of the East Indies, both Mahometans and Hindoos, natives of Polynesia, of China, and of all the countries of Europe, but none of them even approached the "Anglo-Saxon" in downright impenetrability to new ideas.

Take, for example, the curability of leprosy or cancer. I was sent more than thirty-five years ago to investigate a certain reputed cure of leprosy said to have been discovered by a Dr. Beauperthuy of Cumana in Venezuela. I was then occupying an official position, and was sent officially by the then Governor of Trinidad and by the Secretary of State for the Colonies. I reported a number of cases which I had examined, some unfavorably and some favorably. Some were unquestionably cures, if they had originally been suffering from leprosy. I was sent a second time, a year after. I tried the treatment myself and was perfectly successful in one rather advanced case and easily cured some commencing ones. My reports were presented to the British Parliament by command of Her Majesty. Hardly any professional paper noticed them. No proper trials are made of the system, and leprosy is still looked upon as incurable. I, personally, having been physician to a leper asylum, and examined and made notes of hundred of cases, am as convinced that leprosy can be cured as I am that pulmonary consumption can be cured. But it is of no use writing or talking. It is the same with cancer. If you cure a case which was admitted by every one to be cancer, then it was not cancer, because if it had been cancer, it could never have been cured! Same with lupus exedeus. Instead of worrying patients with the Röntgen rays for months, lupus of the very worst

kind is invariably cured in four or five weeks by the use of a drug which is in every pharmacopoeia in the world. It is of no use to publish cases; no one believes them. A long life's experience has taught me that (with the rarest exceptions) unless a man has plenty of money to back him up, unbounded effrontery, and untiring perseverance and energy, he can never succeed in getting any mode of treatment adopted which shocks the prejudices or is contrary to the traditions of the profession.

Progress of Medical Science.

The Boston Medical and Surgical Journal, Dec. 24, 1903. Diffuse (Combined) Degeneration of the Spinal Cord.E. W. Taylor and G. A. Waterman report two cases of this nature. In the first case, the most striking accompanying condition was general arteriosclerosis; in the second case, a fatal anæmia of the pernicious type. The lesions in the first case, though in general similar, were much more diffuse in character than those in the second, and more widespread, though less compact. Some authorities have thought that the converse is apt to be the case. The writers are, in general, strongly inclined to the view that anæmia, arteriosclerosis, and the various other concomitant conditions associated with this now well

deprived type of nerve degeneration are not etiologically significant. They think that a common but as yet unknown cause lies behind, which may be called a toxæmia They believe that these combined lesions may be regarded as either systemic or non-systemic, rather than as a mixture of the two.

Journal of the American Medical Association, Dec. 26, 1903.

Simple Method of Treatment of Hemangioma.-Carl Beck of Chicago describes a method of treatment of nævus which he has employed a number of times with success. The method consists in the general principle of transforming the masses of vessels gradually into connective tissue. Gradually means in several sittings. This is done by a subcutaneous suture. A thread of catgut is passed in a zigzag manner, first below the skin, then underneath the base of the tumor; then, again, underneath the skin, underneath the tumor, etc., until the tumor mass is included in this continuous suture. This suture is drawn tight and closed at the point of the entrance of the needle. In this manner the circulation is shut off within the tumor, but no gangrene follows, inasmuch as some blood can yet reach the parts not included in the suture. After about a week the mass of the tumor seems much smaller. The normal epidermis, however, outside of it, which had been stretched, sometimes to considerable tension, becomes soft and elastic again and grows. This procedure is repeated until the tumor has been diminished to the smallest possible nodule of connective tissue, and the healthy skin enlarged to the utmost. Then the hard connective masses are excised and the borders united. If the tumor is growing in patches, the islands of normal skin will often be seen to enlarge within a few weeks to twice and three times their former size.

Medical News, December 26, 1903.

The Treatment of Some Diseases of the Eye by Warm Medicated Sprays.-David T. Marshall states that spraying with warm medicated sprays is indicated in almost all diseases of the conjunctiva, as acute catarrhal, chronic, epidemic, gonorrhoeal, trachomatous, and phlyctenular conjunctivitis; in diseases of the cornea, as ulcer, infiltration and interstitial keratitis, and in iritis. The method used is as follows: A steam atomizer, such as is commonly used in spraying the throat, is filled with water, the alcohol lamp is lighted and a solution of the remedy indicated is put into the cup. The patient is seated close up to the atomizer. When the spray is well started, the lower eye-lid is pulled down, the eye held wide open and the spray is directed first into one eye and

then into the other. The treatment lasts from five to ten

minutes. After spraying, the eye may be touched with bluestone or alum stick, or applications of drops or ointment may be made as is indicated. These agents seem to act more effectively after the warm spray.

On the Reflex Eruptions of the Skin from Morbid Alterations in the Male Urethra.-A. Ravogli declares that the affections of the skin which originated from chronic disturbances of the urethra, are of a reflex nature and can be reduced to herpes and pruritus. In cases of herpes progenialis the writer makes a thorough examination of the urethra, and he has always found a condition of chronic posterior urethritis with all its complications. In cases of relapsing herpes he states that it is necessary to pay attention to the condition of the urethra and its glands, for they are quite often the cause of the persistence of

the herpes. The local treatment of the herpes is simple. Generally, washing with soap and water, and when dry, the application of absorbent powders, talcum, rice, oxide of zinc, bismuth, etc., give good results. When there is some necrotic condition of the epithelial cells at the bottom of the excoriation, the writer touches up the surface two or three times with a solution of nitrate of

It

silver-from 3 to 5 per cent. He does not approve of the application of salves. Pruritus may affect the anus, perineum, and scrotum. In most cases these regions are affected with eczema, excoriations, and rhagades. is often doubtful as to which affection has the precedence. The writer believes that pruritus is the first. His observations have led him to think that the cause of pruritus is to be found in the condition of the prostatic urethra. In treating this affection, massage of the prostate, or stripping of this gland is of great benefit. It removes the secretion from the body of the glands, thus diminishing the distention locally, the use of ichthyol gives relief from the itching. It also heals up the excoriations. In case of infiltration, the introduction of a sound covered with salve composed of 25 per cent. ichthyol in vaselin has often given good results. This treatment cannot be used more than once a week, and then with caution. After the excoriations are healed and the itching has diminished, application of the following ointment is advised: Benzoin, 5: vaselin, 70; zinc oxide, 25. When the skin has become normal, the treatment is finished by bathing the perineum and scrotum with a carbolic-acid lotion. When dry the skin is covered with rice powder or amylum.

New York Medical Journal, December 26, 1903. Treatment of Typhoid Fever with Castor Oil-According to C. C. Bass, antiseptics in typhoid are too inert to be of any practical value. He believes in purgation. The diarrhoea of the disease is an effort on the part of nature to remove toxic products from the system. If cases are taken early enough before the diarrhoea sets in and the bowels are cleared out often enough with castor oil, there will be no diarrhoea, This clearing out removes toxic products and thus prevents absorption with its fever, etc. The oil is superior to salines which are absorbed into a system already overloaded with abnormal bodies, and by the elimination of the salines, additional work is already put on the skin, liver, and kidneys. The author's experience is based on seventy-nine cases, all of which recovered. Relapses occurred in four. In the majority of instances no medicine whatever was given except the oil. Abundance of pure water was allowed. Fluid diet was persisted in. Hemorrhages occurred three times. Bass advises the use of pure oil every twelve hours, regardless of the stage of the disease. The dose should be so regulated as to cause one or two movements, and will vary from one to eight drachms, depending upon the patient, the stage of the disease, and the condition of the bowels. This should be continued through all stages of the disease.

Larygneal Complications in Typhoid Fever; Report of Case; Tracheotomy; Recovery.-H. Dupuy gives a summary of the literature of this subject and narrates his own case, that of a woman of twenty years. At about the end of the fourth week, signs of laryngeal stenosis appeared. Laryngoscopical examination showed the cords fixed in the median line with only the slightest separation along their posterior borders during inspiration. This was referred to ankylosis of the cricoarytenoid articulations. A high tracheotomy was done and relief ensued. Four hours later the trachea filled with blood-clots from a source that could not be determined. A later attack of heart failure was also controlled and the patient recovered. Ten days after operation the cords began to move, and three days later the larynx was able to carry on both its respiratory and phonatory functions. The author's general conclusions are as follows: Twenty-five cases collected from a period of fifty-eight years give evidence, bacteriological and clinical, strongly supporting the view adopted by the majority of observers, that the laryngeal involvement in most instances is a direct typhoid infection. A high death rate. as shown by statistics, when this complication exists, teaches the salutary lesson of always examining the larynx when the danger signals of hoarseness, dvspna a, or dysphagia set in. The favorable results which follow operative intervention offer such a contrast to the high mortality without operation that there can be but unanimity of opinion as to its propriety. Tracheotomy is the most approved, because in most cases the only possible surgical procedure which can save life.

constipation, and slight fever. These symptoms continued with varying severity for some days and the patient then became jaundiced. Abdominal examination showed a distinct tumor midway between the ensiform cartilage and the umbilicus. It was about the size of the fetal head, somewhat movable and very tender on slight pressure. The patient's condition justified an exploratory incision. The subcutaneous and subperitoneal fat was found to be unusually thick. The latter was so great and contained arteries and veins of such size that we believed, for a moment, it must be omentum. This proved not to be the case, however, and upon incising the peritoneum, the large mass at once presented itself. which was no smaller than the previous palpation and percussion seemed to show. There seemed to be no disease of the abdominal wall fat, in spite of the extensive discase on the inside which involved a considerable portion of the small and large bowel with their omentum and mesentery. The transverse colon lay in a sulcus at its upper part, the duodenum and ileum being intimately attached below and the excessive fat of their omentum and mesentery, which was diseased and lumped together. apparently made the bulk of the mass. The thickened gastrocolic omentum was broken through at the left side of the tumor, to reach the pancreas, which was found to be somewhat enlarged and distinctly attached to the tumor mass by a thick pedicle. Gall-bladder, liver, and spleen normal. The prevailing opinion among the pathologists who examined a piece of the mass was in favor of fat necrosis. The removal of the entire tumor was deemed impracticable and the abdomen was closed. The patient made a good recovery, and one year later was reported as being well. The tumor seemed to disappear. It was considered to be due to a subacute pancreatitis and the initial acute symptoms were referred to a gastroduodenitis.

American Medicine, December 26, 1903.

The Islands of Langerhans in Congenital Syphilitic Pancreatitis. Richard M. Pearce states that the histologic picture of the lesions of congenital syphilitic pancreatitis shows a peculiar relation between the islands of Langerhans and the newly formed tissue. This condition has not been generally recognized. It offers evidences in confirmation of our newer ideas concerning the anatomical and physiological independence of these structures. In all of the ten specimens which the writer reports, the lesion is of the advanced sclerotic type, with almost complete disappearance of the glandular elements. The early stages with infiltration of plasma and lymphoid cells is not seen. The most striking feature is the persistence of the islands of Langerhans, despite the general destruction of the glandular acini. The islands stand out prominently throughout the dense fibrous tissue. They are often surrounded by denser whorls of investing stroma, but are apparently uninjured. Here and there are fragments of gland tissue. In the pancreas of the third month, the islands are still connected with the acini by solid processes of cells. The proportion of connective tissue at this time is very great. Rapid glandular growth does not occur until the fifth and sixth months. Any disease of the pancreas occurring at this time would influence the development of the organ. Evidence of this faulty development would be present at any later stage of the lesion. This appears to be the case in the lesion under consideration. The general microscopical picture of the normal pancreas at the end of the third month is very similar to the syphilitic organ at the sixth or seventh month, except that the latter has a larger proportion of connective tissue. It seems justifiable, says the author, to conclude that the syphilitic infection occurs at the period (third to fourth month) when the islands are still connected with the gland tubules, and that the newly formed tissue causes atrophy of the gland acini, but spares the more resistant islands. The ultimate factor in this resistance of the islands is their abundant blood supply. This supply, the author has demonstrated. is not altered in syphilitic pancreatitis.

Sarcoma of the Abdominal Wall, and Probably of the Pelvic Viscera, Which Has Disappeared under the Use of the Röntgen Rays.-George Erety Shoemaker reports this interesting case: The patient when first seen by the writer was aged thirty-six, had been married twenty years and had had three children. There was no specific history and no enlargement of the glands in the groin or occiput. She was referred to the writer in November, 1002, on account of a growth in the lower abdomen. There was a history of irregular hemorrhage from June to August, 1002, followed by enlargement of the abdomen and an inflammatory attack which began August 7, with a chill followed by temperature of 104° and perspiration. There was no vomiting and on diarrhoea. The soreness, which had continued ever since, was worse in the left ovarian region. Examination showed a swelling

in the median line just above the pubic bone, and apparent ly continuous with it. This swelling had appeared during the illness already described three months before. It had been so sensitive that a large amount of opium was necessary for its relief. This mass was about two and a half inches in diameter, dark red, smooth, rounded, and immovable. It appeared to infiltrate the tissues at the insertion of the recti muscles into the pubic bone. There was some tenderness. The skin was not broken. The patient suffered from almost constant severe pain in the lower abdomen, bearing down in the bladder, and frequent urination with pain at the end of the act. As a pelvic mass was detected to the left of the uterus abdominal section was performed above the limits of the superficial tumor but below the umbilicus. The rectum, uterus, and the left tube and ovary were massed together by an apparent infiltration, but had a certain range of motion. The tumor in the lower abdominal wall was united to this mass by a process of thickened tissue a little to the left of the median line. The whole appearance suggested a new growth, which it was thought unwise to remove. The incision was closed and a cut made directly into the suprapubic growth. Examination of the piece removed for that purpose showed that the mass was sarcoma. Treatment by the Röntgen ray was begun after the healing of the upper wound. This treatment continued for about nine months in all. The total number of exposures was forty-nine. The improvement was remarkable. The pelvic enlargement rapidly disappeared. A year after coming under observation the infiltration of the abdominal wall was entirely gone. There was no pain or soreness. The uterus was in normal position and was freely movable. The patient had increased in weightsixteen pounds during the past five months. She was sleeping and eating well. She stated that she was feeling better than she had for the last five years. The question arises in consideration of this case as to whether the pelvic mass and the tumor in the abdominal wall were of the same character. This mass, if not sarcomatous, could only have been inflammatory. The writer does not believe that the condition was the result of inflammation. The result in this case is so far more favorable than those usually reported.

The Lancet, December 12, 1903.

Inoculations with Haffkine's Plague Prophylactic.— C. E. P. Forsythe reviews the results in 30,609 cases. Of this number of patients but 329 were attacked by the plague, and of these 50 died, a mortality rate of a little over 15 per cent. Some of the patients attacked were inoculated in the incubation period of the disease. The only outward consequence of the inoculation was the development of abscesses at the site of inoculation in sixteen patients. All but one of these were traced to a particular bottle of the remedy, which in some unknown way had become contaminated.

Some Observations on Over 6000 Inoculations against Plague. This paper records the experience of J. W. Miller in the Punjab. Inoculations were generally made in the left arm. Strict asepsis was observed. The author thus describes symptoms following the operation. Aching begins at the site of inoculation a short time after the operation and gradually increases so that as early as one hour after inoculation some pain is felt on movement and in addition some stiffness and a feeling of heat in the arm. These symptoms gradually become more marked, and usually the local symptoms are most pronounced the first evening after inoculation, assuming that the person has been inoculated in the morning. A rise of temperature is perceptible a few hours after inoculation. One abscess resulted out of the entire number of inoculations. It is not stated whether or no the inoculations were universally successful in averting the plague.

Symptomatic Parotitis Following Strangulated Hernia.The patient of F. B. Jefferiss was a woman of sixty-eight years with strangulation of an umbilical hernia of some years' duration. Operation was without incident. On the fourth day after, the patient who had been doing well, had a fever, dyspnoea, and dysphagia. The right parotid was considerably swollen, and later the swelling extended to the right submaxillary. She had been a sufferer from chronic bronchitis, which seemed to take a fresh start. Respirations were forty per minute and her general condition very bad. She died on the fifth day after the operation, twenty-four hours after the onset of the parotitis to which the fatal result is ascribed by the author.

Deformity of the Heart in the Mongolian Imbecile.-Three cases are described by C. H. Fennell, as follows: Case 1. Male, aged twenty-seven years, a low-grade imbecile, in good health, and not at all anæmic. The area of cardiac dulness extended one and a half fingers' breadth

to the right of the sternum; on the left side it reached the nipple line. A to-and-fro murmur was heard in the upper three intercostal spaces on each side of the sternum, but best in the second left space and better along the left sternal border than the right. There was no cyanosis or clubbing, and the patient has had no syncopal attacks and his heart worked adequately. Case 2. Female, aged nine years, a low-grade imbecile of well-marked_Mongolian type, in fair health but subject to catarrh. The area of cardiac dulness extended one and a half fingers' breadth to the right of the sternum; its left limit was half a finger's breadth inside the nipple line. There was a diastolic bruit at the left base, replacing the pulmonary second sound and best heard in the second left intercostal space. No systolic bruit was audible. The child showed no cyanosis or clubbing, but the circulation in her extremities was poor. She was rather torpid and inactive and showed no signs of cardiac failure. Case 3. Male, aged thirteen years, a medium-grade imbecile in good health. The area of cardiac dulness was not increased toward the right; on the left it extended beyond the nipple line by a finger's breadth. A double murmur was present at the base and was heard better on the left side. There was a loud apical systolic murmur heard also all over the left chest and to a less extent over the right chest also. Α systolic thrill was felt at the apex. There was no cyanosis or clubbing and the heart acted well.

The Lancet, December 19, 1903.

Persistent Superficial Nasal Hyperemia Cured by the Removal of Adenoids.-The patient of Wyatt Wingrave was a man aged twenty-one years who, for two years, had complained of intense and persistent redness of the nose. The latter was not obstructed, but there was a large crop of adenoids. The supranasal vein was quite prominent. The adenoids were removed as was also the nasal abnormality. The relation of adenoids to an enlarged supranasal vein is of interest and admits of several interpretations: First there is the mechanical, in so far that the adenoids themselves directly interfere with venous return, thereby producing the prominent supranasal venous arch in infants, so often the subject of superstitious dread. Further, again, their interference with breathing leads to a general increase of venous pressure which the vessels in question specially show. A second view is that the adenoids are responsible indirectly by causing a reflex inhibition of a local vasomotor influence. This may be the interpretation in the present instance, while the first view will be more applicable to children.

After History of a Case of Extragenital Chancre.-The patient of S. Snell, a young woman of twenty-one years, was first seen in 1882. There was a chancre at the inner canthus, caused by infection from a syphilitic child for which she cared Marriage was contemplated and was consummated (against advice) about nine months later. She was seen again by the author some ten years after. She had had five miscarriages, finally giving birth to a full-term child, which remained healthy until it was ten months old, when it had convulsions and became paralyzed on the left side. The mother had remained in surprisingly good health. Later the child had an interstitial keratitis and other stigmata of syphilis. Finally in March, 1903, the mother came under treatment for interstitial keratitis. The author regards the case as of great interest for many reasons, among which are the following: (1) the situation of the chancre; (2) the characteristic history of the patient's children; (3) the fact that one of the children came under treatment for typical interstitial keratitis: and (4) the circumstance that the patient herself suffered from interstitial keratitis, which is only rarely met with in instances of acquired syphilis, and which is additionally interesting in this case from the complete history that can be recorded and from the late appearance of the keratitis.

A Case of Arterial Thrombosis of Gonorrhoeal Origin.The case is reported by F. C. Moore, his patient being a young man of twenty years, suffering from early dry gangrene of the leg. He had had a chill four days before being seen, his left leg had become cold and painful, getting progressively worse, and he had taken to bed. A purulent discharge escaped from the urethra. The leg soon presented a discoloration, the right leg soon began to become affected as the left had been. His general condition grew progressively worse and he died on the eighth day after his initial chill. Autopsy showed the aorta free as far down as the renal branches, but below that situation it was completely occluded by firm, reddish-gray, adherent thrombus. The upper end of the thrombus was inclined obliquely from the orifice of the left renal artery above down to the wall of the aorta below the orifice of the right renal artery. The left renal artery itself was also occupied by similar but rather softer thrombus extend

ing into its several subdivisions in the hilum. The right renal artery was free from thrombus and appeared to be quite healthy. Below, the thrombus continued in its completely obstructing form into the common iliac arteries and along these into the external and internal iliac arteries on both sides. In the external iliac arteries it extended on the left side into the common femoral artery, and on the right side to within half an inch of the pelvic brim. The internal iliac arteries and their secondary branches were similarly occupied by thrombus. The author advances two theories (inclining toward the second) of the mode of infection: (1) infection of small branches, possibly prostatic, of the internal iliac arteries and the development of an ascending gonorrhoeal thrombo-arteritis; or (2) infection of the intima of the common iliac arteries by organisms present in the general circulation.

British Medical Journal, December 12, 1903.

The Behavior of Cancer within Nerve and Trophic Areas.-G. Lenthal Cheatle shows that the spread and limitation of cancer in the skin and muscles bear a marked relationship to the presence of nerves. and the absence of nerves where normally they previously existed bears a marked relation to the limitation of cancer. The writer cannot say whether cancer can genetically arise in a completely denervated area. This disease can exist for a considerable time in a completely denervated area, although it does not spread in that area. It is not alone rodent ulcer that follows definite areas. Benign, but diffuse, papillomata of the tongue show remarkable middle line limitations. Squamous epithelioma, beginning on the lip or elsewhere on the nasolabial region with remarkable regularity, covers the whole area, and apparently rather than leave that area it fungates.

On the Treatment of Cancer.- Lovell Drage concludes that: The condition which the treatment of cancer is designed to produce is first a leucocytosis; and secondly, a fibrosis in the tissue affected by cancer. In the case of pulmonary tuberculosis there is no difficulty in producing these conditions; in that of cancer much greater difficulty is experienced in advanced cases than in the case of tuberculosis. However, it is claimed that the treatment is soundly based, and that although it is quite likely that the best possible means of initiating the changes desired has not yet been found, it is only a matter of time for improvement in the details of treatment to be effected. Success in the treatment of cancer must depend to a great extent upon the physical condition of the patient, and to some extent upon the part of the body attacked.

Nature and Physiological Action of Radium Emanations and Rays, with Observations on Other Rays.-Dawson Turner states that the distinguishing radioactive properties of radium are that it gives off a radio-active emanation and three kinds of rays-x-rays, b-rays, and y-rays. It maintains itself constantly at a higher temperature than its surroundings, and it continually emits heat at an estimated rate of about one hundred calories per gram per hour. The emanation is of the nature of a luminous gas, which can be condensed by intense cold, and which imparts radioactivity to objects in its path. Though the microorganisms of certain diseases are not very susceptible to radium rays, the human tissues are. It is unsafe to carry radium about in the pocket. The chief physiological effects of radium, so far known, are: Effects on the skin, producing infiammations and ulcers. Effects on the nervous system, producing paralysis and death. Luminous effects produced in the partly blind. The radiations of radium have been tried in various diseases, and have been found in many cases to have distinctly

beneficial effects.

The Parasitic Theory of Cancer.-H. G. Plimmer presents various reasons why he thinks we dare not at present give up the parasitic theory of cancer. During the last few years there has been an increase in the number of cases of cancer which is out of all proportion to any known general cause, except a parasite. There are also recorded many instances of relative increase in the frequency of cancer which may be called epidemics of cancer. These epidemics are easily explainable from the parasitic point of view. In many districts the death rate from cancer is abnormally high, and it varies greatly in the same district at different times. This seems to be explained only by the presence of a parasite, which in certain places and times finds better conditions of existence for itself. The disease has a predilection for low-lying damp districts, and especially for those which have both wood and water. Lately a number of facts have been brought forward showing its incidence in certain houses Certain authorities believe that the probable source of infection is often uncooked vegetables. There are certain definite bodies which are found in cancer. They are round and contain a very small, more or less central body,

surrounded by a very delicate substance. These bodies have very definite reactions to certain stains. The living cells of the cancer should be examined in their own juices, or in serum, on the warm stage. The bodies previously referred to, are not to be found in other structures aside from cancer. It has been known for centuries that cancer is locally contagious-for example, between the upper and lower lips. The inoculation of cancer from animal to animal of the same species has been often successfully done. The writer then calls attention to the clinical course of the disease, its beginning in one spot, its extension to distant parts by lymphatic or blood ways, the cachexia out of all proportion to the extent of the disease, the spread by contagion, the occurrence in certain parts of the body, and its return after years of quiescence—all of these facts being explainable by the parasitic theory.

British Medical Journal, December 19, 1903. Ovariotomy on a Patient Aged Seventy-nine Years.Thomas North presents the history of this case. The patient was a widow aged seventy-nine years. She had had six children. She had had no illness of any kind till five or six years ago, when she noticed a swelling on the right side of the abdomen. This continued to increase. Recently, she had suffered much from a feeling of distention and shortness of breath. Operation was performed, and an ovarian cyst containing twelve pints of clear fluid was removed. The patient made an uneventful recovery, and now, four months later, is in good health, and going about daily.

Carboluria Due to Salol.-John Wm. Taylor reports this case. He prescribed salol in five-grain tablets for a woman of forty-three years suffering from flatulent dyspepsia. He ordered one tablet three times a day after food. After the administration of six tablets, the urine became olive green in color and gave a purple reaction with dilute liquor ferri perchloridi. The salol was discontinued, and thirty-six hours later all trace of carboluria had disappeared. There were no other symptoms. The symptoms of carboluria in this case, the author believes to have come on exceptionally soon.

The Etiology of Beriberi.-William Hartigan declares that his experience in Hongkong proves beriberi to be a place infection. He gives various instances to prove this fact a batch of healthy Chinese carpenters were shipped from Hongkong to Aden for shore work. Within a month all suffered from beriberi, the rice consumed on the voyage and afterward, being the same as that eaten by other natives who were not attacked. Three successive batches occupying the same quarterswere also stricken. The quarters were then thoroughly disinfected and a fifth lot lived in them with impunity. The writer relates other incidents which tend to prove the point which he emphasizes that rice eating is not the cause of beriberi. Deutsche medicinische Wochenschrift, December 10, 1903' Experimental Syphilis.-Metschnikoff and Roux inoculated a female chimpanzee with syphilitic virus and produced a characteristic hard chancre which appeared at the end of twenty-five days. A month later fifteen squamous pustules appeared on the body of the animal' which also were typical in nature and persisted unchanged for a month. The animal died at about this time of pneu monia. Some of the virus had been inoculated on the penis and thigh of a male animal on the forty-fifth day of the female's disease, and on the thirty-fifth day the male displayed analogous local lesions. The animal died on the forty-fifth day without having presented any secondary syphilitic lesions, but the results in these two cases are sufficiently marked to allow the conclusion that much is to be learned concerning syphilis by experimentation on the anthropoid apes.

Can the Virus of Rabies Be Filtered?-Celli and Blasi made a solution from the brains and spinal cords of experiment animals by mincing the organs, mixing them with sand and expressing in a Buchner's press under a pressure of 300 atmospheres. The juice so obtained was diluted when necessary with distilled sterile water and infected with several loops of fresh virus. It was then filtered through the ordinary small Berkefeld's filters by the aid of a filter pump. Experiments were made both with street virus and with fixed virus. Nearly all the animals inoculated with this product died, only three out of twenty-three rabbits survived, and every one of four dogs died. A large proportion of the animals, however, did not display the usual symptoms of rabies, and after death no discoverable lesion could be found. The bodies considered by Negri as the parasites of rabies were found in the brains of one rabbit and one dog. The authors conclude that the virus is, under certain circumstances, susceptible of filtration.

Immunization against the Tubercle bacillus.-Friedmann has found that a certain tubercle bacillus which is

invariably fatal for turtles is without effect on guinea-pigs, and, furthermore, confers on them complete immunity against the human tubercle bacillus. Animals injected with the usual dose of virulent bacilli after a preliminary treatment with turtle tubercle bacilli not only did not die, but on autopsy the only lesion was an occasional small round-cell accumulation. The fact that guinea-pigs, the most susceptible mammals, can thus be treated with a variety of tubercle bacilli pathogenic for a poikilotherm, and rendered immune, leads to the belief that similar treatment can be carried out on all other warm-blooded animals with equally satisfactory results.

Berliner klinische Wochenschrift, December 7, 1903. The Treatment of Articular Rheumatism with Menzer's Antistreptococcus Serum.-Schmidt treated fifteen cases of rheumatism that had resisted all other measures, with Menzer's serum. Regarding the results from the most objective standpoint, six cases showed distinct improve ment, in four the results were doubtful, and in five there was no change. The author's conclusion is that the serum is not a specific one in the same sense as that of diphtheria is, but that it is impossible to deny that in certain cases it does produce favorable results. This is especially true of subacute and subchronic cases, while in the acute and chronic stages it is without effect. In practice the serum should be employed after the usual forms of treatment have been found ineffectual.

The Application of the Lowering of the Freezing Point of the Urine in the Estimation of Renal Function.-Zangemeister says that the value of direct observations of the lowering of the freezing point of the urine in determining the efficiency of the kidney is open to several sources of error. The recently discovered fact that in parenchymatous nephritis the kidney may be unable to excrete an excess of water introduced into the body may cause a urine to be passed the molecular concentration of which is greater than that of a normal urine. The degree of molecular dilution which can be produced by the administration of large amounts of water forms a useful guide in judging of the state of the kidney. The variations in the dissociation index of different specimens of the same urine is another source of error, for on diluting urine the molecular concentration calculated from the freezing point does not sink proportionately, owing to the fact that dilution causes the saline molecules to break up into ions which functionate as separate molecules and so simulate a greater degree of concentration than exists. This objection applies even to twenty-four-hour specimens. Urates may also be precipitated from the urine in cooling, so as to cause the freezing point to rise, and in concentrated urines the water tends in part to freeze first and to cause the freezing point obtained to be that of the unduly concentrated residue. These objections may be met by greatly diluting the urine till the "ideal" freezing point is reached which is not affected by any of these factors. In practice the author finds that according to the concentration of the urine examined a dilution of five to fifteen times permits the "ideal" freezing point to be obtained without any loss of accuracy through excessive attenuation of molecular composition.

Münchener medicinische Wochenschrift, December 8, 1903.

A New Method of Quantitative Pepsin Estimation.— Volhard says that the methods of determining the pepsin content of the gastric juice have heretofore been based largely on animal experiment, and have also assumed that the digestive power of peptic solutions is directly proportional to the amount of pepsin present. Schütz has shown that this is not so, but peptic digestion follows the law that x units of pepsindigest only x times as much as a single unit. Observations with Metts's capillary tubes have shown the various digestive products inhibit digestion to such a degree that constant results are obtainable only in dilutions of one to sixteen of the gastric juice. This dilution is so great as to make clinical application of the otherwise convenient Metts' method impracticable. The author's method, which is not given in detail, is based on the fact that when casein dissolved in gastric juice is precipitated by the addition of sodium sulphate, the acidity of the filtrate bears a constant relation to the amount of pepsin present and the time of digestion.

An Enriching Method for Typhoid and Paratyphoid Bacilli Lentz and Tietz have devised the following for typhoid and paratyphoid bacilli as an analogue to Koch's method of enriching cholera stools. The stool is mixed with double the amount of physiological salt solution. One to two-tenths of a cubic centimeter of the mixture are sown on an agar plate to which malachite green has been added in a proportion of about 1-6000, and on two litmus-lactose agar plates, as in the method of DrigalskiConradi. After twenty hours in the incubator, if no typhoid colonies are found on the blue plates, suspicious

colonies on the green plate are tested for agglutination. If the result is again negative the plate is flooded with 2 cm. of broth or salt solution, and one loop of this mixture Sown on two large litmusagar plates, after sixteen to twenty hours in the incubator these plates are searched for typhoid colonies. The method is equally applicable to the examination of urine. The property possessed by malachite green of inhibiting the growth of nearly all organisms except the typhoid and paratyphoid bacilli is very marked, the members of the colon group being especially susceptible to its presence, but as different specimens of the dye vary somewhat in nature, central tests on known cultures are first necessary to determine the proper concentration of the solution to be added to the agar plates.

Detection and Significance of Minute Quantities of Blood in the Stomach Contents and Faces.-Schmilinsky says that the detection of macroscopically undiscoverable quantities of blood in the contents of stomach or intestine is receiving greater attention, and that distinct value attaches to it. Occult bleeding is frequent in ulcer and almost constant in carcinoma. Severe disturbances of motility also can produce such hemorrhages, but in other conditions they are rarely seen. The presence of blood alone is, however, not sufficient to establish the diagnosis, and the other symptoms must be given due weight. It is a sign of particular value in early carcinoma, while the disappearance of the blood after bland diet and lavage makes malignant disease unlikely. Negative results have less value than positive ones. The author has found a modification of the guaiac reaction the most satisfactory. The usual spectroscopic test for acid hæmatin may be improved upon by transforming the hæmoglobin into hæmatoporphyrin by the addition of an excess of concentrated sulphuric acid. The spectrum produced is sharp and easily recognizable, but the test is inferior to the guaiac reaction. The hæmin test is particularly unreliable. Owing to the danger of contaminating stomach contents with minute quantities of blood through abrasions produced by the tube, it is preferable, after two days of gentle purgation and diet free from meat or chlorophyl, to examine the faces. The stool is made uniform in composition by trituration in a mortar, and a small portion (the size of a hazel nut) treated with onethird its volume of glacial acetic acid. It is then extracted with 10 c.c. of ether, and the separation, if necessary, facilitated by the addition of a few drops of absolute alcohol, or a little more ether. The ethereal solution is filtered and five drops of guaiac solution, and ten drops of ozonized oil of turpentine added. Large and moderate amounts of blood give the classical blue color, but this appears only after a succession of other shades has first been run through. Traces of blood may not suffice to carry on the changes to the final blue stage, and hence the formation of a deep green or brownish red is very suspicious, and should always be regarded as an indication for repetitions of the test with more concentrated material, or other stools, etc.

The

Lactic Acid Fermentation in the Stomach with Especial Reference to the "Long Bacilli."-Sandberg calls long bocilli those usually referred to as Boas Oppler bacilli, or the bacillus geniculatus. Various degrees of significance have been ascribed to these organisms which habitually outnumber all others in cases of gastric carcinoma with pronounced lactic acid formation. The author found two forms present in such stomach contents which differed somewhat in morphology and cultured characteristics, but which he was able to prove were the same organism. parent type is composed of short rods, but as soon as they are able to exert their lactic-acid-producing properties or are in a medium in which other organisms are actively forming lactic acid they change to a longer form. These long and short types grow in distinctive colonies between which transitional forms may experimentally be produced. The predominance of the long bacillus in certain gastric disorders is due to the fact that they possess a special resistance for lactic acid which is not common to other fermentative bacteria. They are able to develop when lactic acid is present in the stomach contents in amounts sufficient to check the growth of all other lactic-acid formers, and therefore ultimately to outgrow all of these. The irregularities of the gastric mucosa produced by a carcinomatous growth also tend to form small collections of fluid differing in composition from the general secretion, and thus explaining instances in which the bacilli are present with but small quantities of lactic acid.-Zeitschrift für klinische Medicin, Vol. 51, Nos. 1 and 2.