YEARLY SUBSCRIPTION, $3.50. SINGLE COPIES, 10 Cents. ordinarily, rarely read or discuss a paper, will, as a rule,

Entered at the St. Louis Postoffice as Second-Class Matter. the profession.

physicians of that section and a more active participation in the work of the Association.

Western Ophthalmological, Otological,
Laryngological and Rhinological
Association.

The benefits accruing to the medical profession by an active participation in medical meetings in general and The Committee of Arrangements calls the attention that of State societies in particular are numerous. Aside of the profession to the benefits derived from a numer- from the discussion of the principal scientific questions ous attendance of this meeting, and in addressing the and medical problems of the day, the organization of the physicians of Southern Illinois it says: united medical profession of each State is of considera. "It is now sixteen years since our State Medical As-ble benefit and importance on account of the influence sociation met south of the O. & M. Railroad. One of and pressure that may be brought to bear upon State the reasons advanced by its members in excuse of this legislation. Well directed and prudent efforts in this condition of affairs was the lack of interest displayed direction must, necessarily, redound to the benefit of by the profession of Southern Illinois as demonstrated the profession as a whole, as well as to each of its indi. by their non-attendance and non-participation in the ac-vidual members. tive work of the Association. It is unfortunate that our section of the State should be deprived of the valuable material which each year is offered to our profession through this channel, or be denied the benefits of associations which act as stimuli to our own researches and development. To obviate in a measure the stigma The second annual meeting of this Association will which we felt rested upon us individually and collec. take place at St. Louis, Mo., April 8 and 9, 1897. The tively the physicians of East St. Louis and members of Planters Hotel has been selected as the meeting place the profession from other sections of Southern Illinois of the Association, where the first session will be opened territory attended the State Association at Ottaway last at 9 A.M. The address of welcome will be delivered by May, and in behalf of our profession in Egypt, invited Dr. W. J. Langan, the popular President of the St. them to hold the next session here. In doing this we Louis Medical Society. A response will be made by morally pledged the attendance of every doctor in good the well known Dr. A. C. Corr, President of the Illinois standing from Springfield to Cairo. This will not bind you to become a member, although it is desired that you The next prominent speaker on the programme is Dr. do so, but it is our aim to make this meeting a memora Adolf Alt, of this city, who has chosen for his annual ble one not only in respect to the attendance but in re-address the subject of "Hemorrhagic Glaucoma." The spect to the material presented and the discussion there- succeeding features of the meeting will be the reception on by men of not only National but of International of guests; registering and payment of dues; report of

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reputation. •

"But the success of our arrangements will depend upon you individually, and we trust you will see your way clear to aid us in making good our pledge to the State Association."

State Medical Association.

the secretary and treasurer; the election of members; presentation of papers. Thirty five papers have so far been announced for the first day's session and forty papers for the second day. The election of members and officers forms a part of the programme of the second day. Arrangements have been made for a one and a third railroad fare; cirtificates to be signed by Dr. Alt upon arrival in St. Louis.

The indications are that the meeting will be one of unusual interest and importance.

The officers of the Association are: President, Adolf Alt; Vice Presidents, B. E. Fryer and J. H. Martindale; Treasurer, W. L. Dayton; Secretary, Hal Foster.

The Prospective Pure Meat Ordinance.

Health Commissioner Starkloff is pregaring a bill providing for a more thorough meat inspection, which will provide for the inspection of all live animals intended for human food, and for the inspection of all fresh, dried and salted meats, fish, game and poultry, regulating the sale of meat, etc.

The necessity of a more thorough meat inspection is obvious. Pathogenic germs enter the system princi. pally by way of the respiratory and digestive tracts. Cleanliness in the preparation of food and eating, as well as thorough cooking does much to prevent infec

tion with pathogenic organisms; also the normal process of digestion and natural immunity. Nevertheless there are plenty of chances of infection, especially for the predisposed--not to mention intoxication with tox ins, ptomains, etc.-and the inspection of meat, or for that matter every other kind of food, is not in har mony with the present advanced knowledge of pathol ogy and the etiology of diseases. The thorough and systematic meat inspection of some European cities necessitates almost an army of expert officials, viz.: veterinarians, microscopists, etc.

They will perform their duties under the direction of the chief sanitary officer. The duties to be performed will be designated by the Commissioner.

"It will be their duty to inspect, while alive, all cattle, sheep, hogs and calves intended to be slaughted for food, and also when ordered all poultry, fresh, salted or dried meats, fish and game that shall be offered for sale. They will have authority to enter any place where live cattle may be kept. Any person who interferes with them in the discharge of their duties or refuses them permissiou to make inspections, or tries to conceal animals which should be inspected, will be subject to a fine of not less than $50, nor more than $300.

In 1891 we delivered a public lecture upon this sub ject, emphasizing the necessity of a more methodical and thorough meat inspection and placing particular "The Health Commissioner, with the approval of the stress upon the necessity of the inspection of animals Board of Health, will designate a sufficient number of by competent men before they are slaughtered. We inspection stations. On days and hours announced in then recommended an imitation of the procedures that the paper doing the city printing owners of animals inare now in vogue in some of the larger European cities. tended for slaughter will have to present them at the Since we took charge of the editorial management of stations for inspection, except in cases where the Comthe REVIEW we have called attention on several occa missioner, by a special order, may otherwise direct. The sions to the necessity of a reform in this direction; for penalty for selling meat which was not inspeeted while instance, in an editorial of June 3, 1893, entitled, "The living will be not less than $100 nor more than $500. Hygienic Conditions of the City of St. Louis and Sug gestions as to Its Improvement." Meat merchants and butchers as a rule claim that in this country a careful supervision of the meat market is not so necessary as in Europe because the animals here are, on an average, healthier than those of the thickly settled European countries. There may be a grain of truth in this statement, but we doubt that for practical purposes this is

correct.

While Health Commissioner Starkloff is to be con gratulated upon his laudable efforts in this direction, we must confess a slight degree of doubt as to the probability of securing what is intended by the few men that are to be appointed as inspectors, considering the large amount of work which their duties will involve. In Europe, where meat inspection is carried out in some cities in such a thoroughly scientific and methodi cal manner that it almost deserves the name of an estab. lished science, time is economized by the fact that in one huge building all the cattle are examined alive, then slaughtered and the various organs again examined. All the work of the meat inspection is done in one build. ing; but an army of officials is required to accomplish this object thoroughly and in harmony with modern scientific progress.

The Health Commissioner's contemplated ordinance is, nevertheless, a step in the right direction and one which seems to deserve the unqualified support of the medical profession.

"All animals found diseased must be killed at once

by the owner. The inspector will then mutilate and mark the meat by carbolic acid or coal oil, rendering it unfit for food. A fine of, from $50 to $500 will be ininflicted for failure to observe these requirements.

"Meats, game, poultry or fish found tainted or unwholesome will be multilated in the same way, and put beyond doing harm. For offering for sale meat which was diseased when slaughtered, a fine of from $60 to $500 is provided.

"Any person who kills for human food or offers for sale any calf less than fourteen days old may be fined

from $25 to $100."

The Health Commissioner had a bill intrduced last

May containing substantially the same provisions, but there was a section forbidding the meat of any bull, steer, cow, sheep, hog or calf, which had been slaughtered outside of the city to be brought here and sold as food. This was in conflict with the Interstate Commerce law, and brought about the defeat of the bill. In the new bill this conflict will be avoided, but ample precaution will be taken to prevent the meat of diseased animals slaughtered outside the city being brought here and

sold.

The Laryngoscope, published in St. Louis, has been selected as the official organ, for the year 1897, of

The following is the contemplated ordinance as we the Laryngological Section of the New York Academy glean from a daily paper:

"The ordinance will authorize the appointment by the Commissioner, with the approval of the Board of Health, of a chief animal and meat inspector and three assist ants. All of them will have to be versed in the diseases common to cattle, hogs, sheep and other animals, and two of the assistants will have to be practical butchers.

of Medicine. This selection, and the great probability of the same journal being chosen by other Laryngols. gical, Rhinological and Otological Societies as their official organ, would indicate that The Laryngoscope has become what its proprietors stated they intended to make it, i. e., The American Journal of Record for the specialties represented.

CORRESPONDENCE

Dr. Essick's Defense.

Editor MEDICAL REVIEW.-In your issue of February 6, 1897, I see from the proceedings of the Southern Illinois Medical Association the action taken by that body in suspending me. As you have published that fact, and as I am one of the members who is accused of violating the Code of Ethics, and as a subscriber to your Journal, I desire to give you my version of the manner in which the Board of Censors disposed of my case. I only ask for what is just and fair. Inclosed please find copy of a letter addressed to Dr. DeCourcy, Secretary; please give it space, as I wish all who read your Journal to know the facts:

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MURPHYSBORO, ILL., Nov. 24, 1896. DR. J. O. DECOURCY, Secretary Southern Illinois Medical Association, St. Libory, Ill.

Treatment of Malaria in Infants.-Feuchtwanger (Ther. Monats.; La Presse Med.) has, during five years, experimented with the substitutes and succedanes of quinine in the treatment of infantile malaria. His experience included methyl blue, nitrate of potash, DEAR DOCTOR.-I see in the Centralia Sentinel and tr. turusol. But after a fair and thorough trial of all the St. Louis Globe-Democrat (and have been informed he was compelled to return to the use of quinine. The that the same article appeared in the St. Louis Republic) investigations were conducted in Palestine, where mabearing date of November 20, 1896, that I have been suspended for one year for unprofessional advertising, at the meeting of the Southern Illinois Medical Association, which convened at Centralia, Ill., November 19 and 20, 1896.

laria in all forms is endemic.

In infants the author employed the following treatment: He selects quinine bisulphate as it is better sup ported by the infants than the sulphate, and as the bisulphate does not contain as much of the alkaloid as Now, Doctor, I will say that the action taken against the sulphate and it is therefore better borne by the me by the Association was not only discourteous, but stomach. The author has formulated a rule for dosage unprofessional. In the first place I do not consider that viz.: He gives as many decigrammes as the child is I am a member or was a member at the time this action old in years and as many milligrammes as it is advanced was taken by the Association, as I had sent in my re in months. Thus, if the child is six years old the dose signation to Dr. J. T. McAnally, while he was Secretary can be six decigrammes (nine grains). If it is six of the Association-I think sometime in 1893. I have months old the dose will be six milligrammes (one-tenth paid no dues since my resignation was sent in. I don't grain). In infants under two months the internal adthink the Constitution or By-Laws can hold a member ministration of quinine is replaced by external inuncwhen he wishes to withdraw. I have not attended any meetings of the Association since, as I did not consider myself a member.

Now, Doctor, it is very strange to me that the Board of Censors would pass upon my case without even noti fying me as to the nature of the charges, and giving me a chance for a hearing. Neither the Board of Censors nor the Association can try a member for the violation of any rule without due notice, and his presence at the trial. No law or court will support them in their ac tion. No society on earth can lawfully and legally rec ognize and consider charges against a member without giving him proper notice and a chance to defend him self. * * No matter what the offense, whether it come under the civil or criminal law, and no matter how convincing the evidence, he can not be convicted with out proper notice of the charges and a fair trial before an unbiased court. * *

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The Association suspended me for an advertisement which I discontinued, I think, more than a year ago; no

tions and frictions of quinine in fats. These frictions are to be made in the axillary and inguinal spaces and effect of the quinine thus administered is identical as that from stomach absorption.

In infants of from three to eight months the author sometimes used rectal suppositories, three per day, each suppository containing twice the amount of quinine indicated for a stomach dose. Sometimes the supposito. ries will cause tenesmus. If such is the case quinine enemas can be used.

In neuralgias of nervous origin the author has used, with equal success, valerianate of quinine. In two cases of pernicious malaria with coma, ciliary paralysis, vomiting, hemoglobinuria, etc., hypodermic injections of quinine hydrochlorate were successful. After the third injection of fifty centigrammes (five grains) the hemoglobinuria ceased as if by magic.

If there is a malarial cachexia it must be treated in the usual way with iron, arsenic, etc. But this tonic treatment must only be instituted after a thorough anti

malarial treatment.

Sometimes the treatment of the by intestinal antisepsis have lately been given a rational cachexia is very difficult. The fever will have a per- basis by Chaumier, of Tours, who has called renewed sistent tendency to return and the author advises the attention to the importance of these therapeutic meas. administration of small doses of quinine for a long time. ures. Daily experience teaches us that astringents, like It is well to give a decoction of quinine and tincture of opium and tannin, have no healing influence on tuber. turusol for many weeks. Small doses of diluted hydro cular intestinal ulcerations. What is required is a relichloric acid may be added. Often in spite of this treat-able intestinal antiseptic that shall have at the same time ment the malnutrition progresses. Recourse may then astringent properties; thus lessening the evil effects of be had to large doses of arsenic. A mixture of two the micro-organisms and their products, and making the grammes of the solution of arsenite of potash with mucous membrane a bad culture ground for them. The eight grammes of the tincture of malate of iron is ad- lessinging of the secretion also reduces to a minimum vised. An infant of three years can take five drops of the nutrient materials obtainable by the microbes. Orthe mixture three times daily. Afterwards the dose can phol, or beta naphthol bismuth is such a drug. It is a be increased one drop per day until forty-five drops are light brown powder, prepared by the chemical factory taken in twenty-four hours. Then the dose is dimin. of Von Heyden, at Radebeul, and though composed of ished drop by drop. This treatment by arsenic is con- oxide of bismuth and naphthol, has neither the repulsive traindicated when there is any gastric trouble. In such smell nor the burning taste of the latter drug. It has cases a change of locality is urged. In older children an agreeable, faintly aromatic taste and smell aud con. pills composed of quinine and arsenic are successfully tains 20% of beta naphtol and 80% of bismuth oxide. given. It thus combines an active antiseptic with a powerful astringent agent. And, since in most cases of chronic

chronic intestinal catarrh. The results were entirely good; the stools became formed and regular, and the troublesome symptoms above mentioned disappeared. I select the following case from the series.

The Therapeutic Action of Orphol (Beta-intestinal catarrh abnormal fermentations and decompo. Naphtol Bismuth. Dr. Goliner, of Erfurt sition plays a great part, the disinfection of the alimen (Allg. Med. Cen Zeit., 1896, No. 96) says: Intestinal tary canal is an important therapeutic indication. The ulcerations, occasioned by the breaking down of chees- flatus and distension of the abdomen, the colicky pains, ily degenerated follicles are of not infrequent occurrence the abnormal abdominal sensations, all these symptoms during the progress of pulmonary tuberculosis and, as are due to the activity of the micro-organisms in the is well known, are found most often in the ileum; thence intestine. I had occasion some time ago to try orphol the disease spreads to the colon and even to the vermi- in a series of cases of lung disease that suffered from form appendix. The number of follicles affected varies in different cases, sometimes the gut is fairly sown with them over a large extent of its surface, and sometimes the malady is limited to a small region. When the cheesy central mass softens and is extruded, a follicular A phthisical patient, 52 years old, had complained ulcer is formed, whose tubercular nature is shown by for some time of flatus, abdominal pains, and persistent the presence of granulating connective tissue containing diarrhea. The number of thin stools varied from four miliary tubercles in its neighborhood. The central ne- to ten daily, with occasional attacks of colic. Although crosis progresses, and the ulcer extends, whilst connec the patient had remained in bed for weeks, and had tá tive tissue, new growth and tubercle formation advances ken opiates, the troublesome diarrheas persisted. He at the margins, and thus the follicular lesions soon de was emaciated and anemic, and the meteoriam was velop into tubercular ulcers. Especially noticeable marked, though there was no especial sensitiveness to among the symptoms that they cause is the obstinats pressure. The stools were almost watery, dirty brown and violent diarrhea, more especially when the ulcers in color, foul of odor, and were plentifully mixed with are situated in the rectum or lower colon. Irritation of the intestine of any kind almost always causes increased frequency of defecation.

mucus, with occasional streaks of blood. I was evidently dealing with chronic enteritis and ulceration of the intestinal micosa. I put him on a bland diet, and gave him 1.0 gm. (15 grains) of orphol after eating, and as this was repeated every two hours, he took 5 gm. (75 grains) daily. The result was a favorable one, the borborigmi eructations and pain were relieved, and three days later constipation set in. The appetite, formerly very bad, improved, and the patient began to gain in weight. Later, his bowels moved once a day and the stools were of the consistency of thick gruel.

The thinness of the stools is accounted for, according to Nothnagle, partly by the pathological secretion from the ulcerated surfaces, and partly by the lessened power of resorption of the diseased intestinal wall, in consequence of which the feces are less solid than usual. When in the course of a consumption there appears an obstinate diarrhea, perhaps mixed with blood, and ac companied by colicky pains, it is extremely probable that intestinal ulceration is present. If peritonitic Orphol influences the mucous membrane of the di symptoms appear, then the ulcerations are approaching gestive tract in two ways. In the first place it is a disthe serous membranes, or they have already perforated infectant, hindering the development of the bacteria. the wall of the gut. It is also an astringent to the mucosa, by virtue of the Our attempts to influence the diarrhea of consumptives bismuth that it contains. It is worthy of notice, also,