ADDITIONAL LABORATORIES OF THE H. K. MULFORD COMPANY.

It is a pleasure to note the growth of the H. K. Mulford Company, as shown by the illustration of additional laboratories recently purchased by the company at Eleventh and Catharine Streets, Philadelphia.

These buildings are being used in connection with their present extensive Thirteenth Street laboratories. In the above group of buildings will be located the crude drug department, their milling and grinding, also the manufacturing of standardized fluid, solid, and powdered extracts, tinc

tures, and of certain synthetic products to which this Company is devoting considerable attention.

The facilities for standardization and assay and the additional equipments of the research laboratories in their Thirteenth Street laboratories, together with the laboratory for the physiological testing of drugs at Glenolden, have been materially increased and strengthened.

All these increased facilities and additional equipment and the services of skilled experts in every department make for a higher degree of excellence and signify that the "Mulford label" can be relied upon with confidence.

Franz Josef Natural Aperient Water.-This is a strong and at the same time a most palatable Hungarian aperient water. Uniform in composition, it regulates the functions of the body without fatigue of the stomach, and is recommended by doctors especially for constipation, liver troubles, catarrh of the stomach and intestines, piles, obesity, gout and rheumatism. Ten gold medals. Sold everywhere.

DIONINE

A MORPHIA DERIVATIVE, FREE FROM INJURIOUS BY EFFECTS. An excellent substitute for Morphine, an approved remedy for the treatment of affections of the respiratory organs,an Analgesic and Sedative. Recommended also in the treatment of the Morphia habit. DIONINE is easily soluble, its solutions are neutral, and therefore the injections are painless. For internal adminis tration-Dionine Tablets, each 0.03 gram. (grain) in original tubes.

¡ODIPIN

10% and 25%. A valuable substitute for the alkali iodides, free from all undesirable after effects. Especially indicated in Asthma, Bronchitis, Emphysema, Arteriosclerosis, Scrofula and Goltre. A specific in tertiary Syphilis. Internally also in the form of Iodipin Tablets. IODIPIN 25% is usually administered hypodermically, and in this way it produces prompt, energetic, and lasting effects.

E. Merck, Darmstadt,

Germany

(FICKER).

ATROPIN-METHYL-
BROMIDE An excellent

Sedative and Analgesic.

Samples and Literature

on

application.

(MENZER).

MAGNESIUM PERHYDROL Containing 15% and 25% chemically pure Mg. 02.

ZINC PERHYDROL

Containing 50% chemically pure Zn 02.

PERHYDROL 100% BY VOLUME

Chemically pure and acid-free Peroxide of Hydrogen. Disinfectant and Deodorant, entirely non-irritating, non-poisonous, odourless. Suitable for all surgical, otological, rhinological, laryngological, and odontological purposes. In original bottles of 50 and 200 grams.

STYPTICIN

Uterine Bleeding, Bleeding

A very efficient, harmless Hæmostatic, with sedative properties. Particularly recommended in from the Stomach, Intestines, and

Bladder, and in Hæmoptysis. Given internally in Tablets, each 0.05 gram. ( grain).

ALSO

Stypticin Gauze-Stypticin Wool.

VERONAL

when given in proper doses, is an innocuous soporific, having a prompt hypnotic and sedative action. Recommended in simple Insomnia due to

Psychical Affections and cases of excitement. Combined with Dionine, highly satisfactory results have been obtained in the treatment of insomnia due to pain.

Veronal Tablets, each 0'5 gram. (7) grains).

When writ ng advertisers, please mention THE CANADIAN JOURNAL OF MEDICINE AND SURGERY.

MODERN THERAPY, SURGICAL APPLIANCES, ETC.

Lloyd's Patent Cable Mattress. The attention of physicians is called to the advertisement of the Lloyd, Thompson Wire, Ltd. (on page lxxiv. of this issue), as to Lloyd's Patent Cable Mattress. This is undoubtedly one of the best mattresses procurable. It is essentially sanitary, most comfortable, and, what is a necessity for use in the hospital or sick room, it will not

sag.

A Notable Gathering on a Notable Occasion.-The Right Hon. Earl Grey, Governor General of Canada, will open the Canadian National Exhibition at Toronto on Tuesday, August 27. He will probably be supported by a company of Imperial notables, including Lord Milner, formerly High Commissioner for South Africa; the Right Rev. Winnington-Ingram, Lord Bishop of London, and sir Daniel Morris, Governor of Barbadoes.

Home Sanitation.-No class of men know better than physicians how all-important it is that the sanitation of the home be the first consideration. A healthy, dry, well-drained basement means almost invariably a healthy family. The day of the boarded cellar floor is past and gone. The only basement floor that can give satisfaction, and that is hygienic in the true sense of the word, is that laid in concrete, not the concrete made of a poor quality of sand mixed with a small quantity of cement, but the kind put down by the Crescent Concrete Paving Co., of Toronto, made up of screened crisp sand and pure Portland cement, properly laid and graded, with weeping drains to guarantee a dry surface. Physicians should bear the name of this firm in mind and give them a trial. Their phone number is Main 1649.

The Very Thing for a Physician.- The peerless Lehman carriage heater gives a continuous heat for fifteen hours from one brick of Lehman coal. We say "peerless" because the Lehman Heater has no peer, no equal, all claims of competitors to the contrary notwithstanding. And it produces this heat without smoke, flame, odor or gas. Think of it. The cost of operating only one-half cent an hour or less. The Lehman Heater produces the most economical heat of the age, without flame and without the slightest danger aris

ing from fire. One-third of a brick is sufficient for all ordinary purposes. Ready for use in about three minutes-no waiting and it renders a vehicle perfectly comfortable in the coldest weather. When your feet are warm your blood is in circulation and you are warm " all over." Write Lehman Bros., 10 Bond St., N.Y., for circular, mentioning CANADIAN JOURNAL OF MEDICINE AND SURGERY.

Journal of Medicine and Surgery

A JOURNAL PUBLISHED MONTHLY IN THE INTERESTS OF
MEDICINE AND SURGERY

VOL XXII TORONTO, OCTOBER, 1907.

Original Contributions.

NO. 4.

EXPERIMENTAL PRODUCTION OF ARTERIO-SCLEROSIS.*

BY OSKAR KLOTZ, M.D.,

Lecturer in Pathology, McGill University; and Resident Pathologist, Royal Victoria Hospital, Montreal.

BEFORE taking up the study of the experimental production of arterio-sclerosis it is necessary to ask, What is arterio-sclerosis? (a) Is it an entity; or (b) are several distinct morbid conditions included under this one heading; or (c), what comes nearly to the same thing, in different states which we are accustomed to regard as arterio-sclerosis, do we find the different coats and constituents of these coats affected diversely?

It is necessary to ask these questions, because, as I shall show, different procedures and reagents have different effects upon the arteries, and whether we are to regard these experimental results as arterio-sclerosis must depend upon an answer to these questions. The subject of classification has been taken by Professor Welch fortunately, therefore, I need not discuss the various forms. All that I need say as indicating my point of view is that I do not agree with Jores' narrower definition. His extensive studies, which have received much attention, have led him to include only a particular histological change in the vessels as coming under the category of arterio-sclerosis, while the mass of other scleroses in the arteries remains unclassified. He and those who follow him would limit the term to conditions of intimal hyperplasia, with a peculiar splitting of the internal elastic lamina, conditions which can only be distinguished under the microscope.

*Read before meeting of the British Medical Association, Toronto, August, 1906.

Are we, then, to exclude the clinician from diagnosing arteriosclerosis? The answer can but be, No! And this for the adequate reason that such is not the sense in which Lobstein applied the term arterio-sclerosis in 1835. Let us preserve the broader meaning, and regard all scleroses or hardenings of the arteries as included under this general term, recognizing, if need be, distinct varieties.

Thus I would point out that arterio-sclerosis is not a simple disease. Although, in some instances, a single coat of a vessel is found affected by a fibrous or other allied change, in others several tunics of the same artery are involved. Again, we may find that in a certain form of sclerosis particular tissue elements are picked out, while other tissues are unaffected, or that when muscle fibres are degenerating in the media the connective tissue elements of the intima are proliferating. Hence we find that we may have two or more such processes inextricably mixed in a progressive disease of the arterial walls.

Of the more common forms of sclerosis of the arteries I would point out that the hard radial vessels by which the clinician makes his diagnosis of arterio-sclerosis is a widely different disease from that recognized by the pathologist at post-mortem examination of the aorta. The sclerosed radial vessels represent a disease which is peculiar to the media; it has its origin in the muscle cells of the middle coat, and the middle coat alone is damaged. The intima and adventitia are not essentially involved in the process, though occasionally a secondary intimal thickening accompanies the medial degeneration. The main changes in the media are a fatty degeneration of the muscle and later of the elastic fibres, both of which become calcified. It is through these calcareous plaques in the media that the beaded character is given to the radials. At these sites of medial degeneration and calcification the vessel wall is perceptibly thinned, so that many small pouchings result. These pouchings, though small, are true aneurysms distributed irregularly in the vessel wall, and when held to the light are seen to be thin and quite transparent. This type of disease, which is most frequent in the vessels of the extremities, I shall later speak of as the Moenckeberg type of arteriosclerosis, and I shall point out how closely some of the experimental lesions resemble it.

On the other hand, the nodular aorta, which we so frequently meet with at autopsy, is the result of repeated insults telling upon the intima alone. The thickenings of the intima may again be entirely proliferative, and in this case represent a chronic inflammatory production. This I acknowledge is not the view held by all; those who still uphold Thoma's conception of the arterio-sclerotic process see also in the typical nodose sclerotic aorta a primary giving way of the media, and regard the intimal