mines of Europe kill only from 1 to 2 per 1,000 men employed. In 1907, in the United States, 3,125 miners were killed, a mortality rate of 4.86 per 1,000 men employed. Are men cheaper than methods of prevention? Waving aside all figures showing the economic loss to the workingmen, their families and the community, losing sight of the immense loss through liability insurance and the costs of damage suits, even dismissing from thought the actual cost in hospital and dispensary expenditures, surgical fees and surgical supplies, we ask for the sake of the workingman that adequate protection be given to lessen his surgical burden of preventable accidents. In this connection we rejoice that an American Museum of Safety has been organized for the purpose of enlightening employers and employees and the public generally of the most satisfactory means of preventing industrial accidents. Similar museums exist in Berlin, Paris, Vienna, Milan, Munich, Stockholm, Budapest, Zurich, Amsterdam and Moscow. All save the museum at Vienna are supported by the state. The duty of the surgical profession is clear. Whenever possible, its united voice should be raised in behalf of beneficent prevention of industrial accidents. Prevention of accident is as essential to the welfare of the nation as the prevention of disease. American Journal of Surgery. Salvarsan in Pernicious Anaemia. Bramwell states that since he began to treat pernicious anæmia by arsenic in 1875, he has had a large experience. The results of his observations show that in a large proportion of cases marked improvement, and, in many cases, temporary cure, result from the arsenical treatment; that the improvement is greatest in first attacks and in cases in which the patient can take large doses of arsenic; but that in the great majority of cases, notwithstanding the arsenical treatment, relapses occur, and death ultimately takes place. He now has tried salvarsan. The two patients had received Fowler's solution, which was discontinued. Both received four doses (0.2, 0.3, 0.3, 0.3 gramme, and 0.3 gramme four times) of "606" intramuscularly. In both cases very marked and continued improvement has resulted, both as regards the condtion of the blood and the general symptoms. Infectious Agent in Whooping Cough. Menschikoff, in Russij Wratsch, draws attention to the investigations of this subject by various authors and then gives the results of his own control experiments made with the Bordet-Gengou bacillus of tussis convulsiva. The cultures of the bacillus obtained by him from the sputum showed rapid growth upon a nutrient medium consisting of glycerin-agar with considerable addition of blood human. These cultures were very toxic for animals. When the culture medium contained only a small amount of blood, the virulence of the microorganism was diminished. That these infectious agents are specific for pertussis is rendered probable by the following: (1) In very small children who previously were free from affections of the lungs and respiratory passages, the bacillus was present in enormous numbers in almost pure culture in the sputum during the course of whooping cough. (2) The blood serum of pertussis convalescents agglutinates the bacillus. (3) Fever and cough were produced in monkeys and dogs by infection with pure cultures of the bacillus (Klimenko); also animals which came in contact with infected animals sickened and manifested the same symptoms, and the same bacteria were found in their bronchial secretions. While other authors found the Bordet-Gengou bacillus only in the catarrhal stage and during the first to second week of the convulsive stadium, the author was able to demonstrate them even during the sixth to eighth week of the disease, although in small numbers. A young lady who taught a class of small boys in the Sunday school desired to impress on them the meaning of returning thanks beore a meal. Turning to one of the class, whose father was a deacon in the church, she asked him: "William, what is the first thing your father says when he sits down to the table?" "He says, 'Go slow with the butter, kids; it's forty cents a pound,' "" replied the youngster. "What are you doing on the street at this time of night, children?" "Ma's sick." "And you are going for medicine?" "No, beer! Papa's got to sit up with her!" Elimination of Hexamethylenamine by the Mucous Membrane of the Middle Ear and Nasal Sinuses. In the Boston Medical and Surgical Journal of June 30, 1910, Barton reaches the following conclusions: 1. Hexamethylenamine is eliminated by the mucous membranes of the middle ear and accessory nasal sinuses. 2. Judging from the limited data at hand, it would appear that the drug is of considerable value in cases of acute suppurating otitis media and sinuses. The chronic forms are apparently benefited. 3. Upon a priori grounds it may be fairly assumed that hexamethylenamine may prove to be a valuable prophylactic in those diseases commonly attended by otitis media; perhaps also a prophylactic to be used prior to surgical operations upon the middle ear, the mastoid, and the sinuses of the nose.-Therapeutic Gazette. Nitrous Oxid-Oxygen Anethesia. R. C. Coburn, New York (Journal A. M. A., February 18), points out the advantages of the use of the nitrous-oxid-oxygen combination for general anesthesia in preference to the usual anestetics employed. It is a mistake he says to think that it is better adapted for minor surgery and short operations than for major work, for the longer this anesthesia is maintained the better it becomes in every way. He has used it in difficult and complicated operations lasting over four hours, and he quotes the testimony of other surgeons to the same effect. The destructive action of ether and chloroform on the blood and the consequent greater liability to infection by destruction of leukocytes is noted as well as the irritant effect of ether on the organs of respiration. It is the remote effects of these other anethetics that seem most to be avoided. With nitrous-oxid-oxygen these are absent and he assents to the statement of Gatch that very ill patients with rapid pulse and quick shallow respiration actully seem benefited by this form of anesthesia. He quotes the testimony of a patient that anesthesia by this method was like a pleasant dream as showing how much it describes the discomfort to the patient. Difficulties in the Diagnosis of Chancre of the Tonsil. La Play and Sezary (Abst. in Cb. f. Bacteriologie 48-23709) point out that to distinguish between a Vincent's angina and a chancre of the tonsil is often impossible from the macroscopic appearances. Only the ultramicropscopic examination can decide the point, in some cases, and even this method is not infallible, since in the pharynx, beside the Treponema Pallidum, a number of other spirilli, some of them almost exactly like it, may sometimes be found. In distinguishing between these, the most important differential point is that the Treponema does not stain with methyl blue, remaining unstained even after an hour's exposure to the solution; while the other spirilli take up the methyl blue in a few minutes. There can be no question of the great importance of Vincent's angina as a stumbling block in the diagnosis of syphilis of the tonsil. Dr. Wherry of Omaha has also pointed out this danger. Without doubt many cases of Vincent's have been diagnosed as syphilis, and the patients made the victims of much unnecessary treatment and alarm. All physicians should be on guard against this mistake or the analogous one of mistaking Vincent's for tuberculosis. GIFFORD (Omaha) Bird Shot Removed From Eye Three Years After Accident. An unusual outcome to a bird shot accident, is reported by Laas (Klin. Monatsbl. f. Augenheilkunde, Feb., 1911). In 1907, his patient received a charge of shot in the face. Each eye received a penetrating wound of the interior half, with sight reduced to counting fingers. The radiographs were hard to interpret on account of the number of shot scattered through the tissues of the orbit and face, but as near as could be told, 1 shot had gone clear through the right eye, lodging in the tissue just behind it; while another, w hich had penetrated the left eye, remained in the posterior part of the vitreous. As the right eye had much the better vision, Laas would have been following the best of authority if he had removed the left eye on account of the shot which it contained. However, since it showed no signs of infection, he decided not to enucleate; a very fortunate decision as the event proved; for the right eye, though it continued to have useful sight for a year or more, went entirely blind from detachment of the retina, while the shot in the left eye, after remaining without causing irritation for three years worked its way around without the dislocated lens, appeared in the anterior chamber and was extracted with a comparatively excellent result. The eye retained enough sight to permit the man to find his way about readily and to carry on the direction of his business. GIFFORD (Omaha). WESTERN MEDICAL REVIEW A JOURNAL OF MEDICINE AND SURGERY Published Monthly by Western Medical Review Company, Omaha, Nebr. Per Annum, $2.00. The Western Medical Review is the journal of the Nebraska State Medical Association and is sent by order of the Association to each of its members. Within the last few years many new biological substances have been used as therapeutic agents and as a result a number of new terms have been introduced into medical literature, some of which are not always clearly understood. Therapeutic serums. These consist of the blood serum of some animal (usually the horse), which has been inoculated with the germ or toxine of the disease which is to be treated by it. They contain, in a concentrated form, the anti-bodies developed by the animal organism to combat the invading disease. Serums are said to be univalent when the inoculation was made with a pure strain of the organism used, or polyvalent when a mixed strain was used in inoculation. Serums are administered by |