The

The Treatment of Disease by Blood Serum and Anti-Toxines.

The march of medical science is at present so rapid that one must be constantly alert lest he unexpectedly find himself a straggler, far in the

rear.

When we remember that the sciences of physics, chemistry and biology are all contributing their wealth of new discoveries to the one composite science of medicine, in which they find their practical application, there ceases to be any wonder at the rapid progress.

The decade from 1880 to 1890 was especially marked for the activity with which the various disease germs were isolated and studied, and their identity as the causative factors in their respective specific diseases demonstrated. Along with this went the incessant search for chemical destroyers of these germs, as the proper specific treatment of these special diseases. The chemical laboratory revealed the fact that many of the

most successful old-fashioned remedies for the class of diseases in question, whose value had been determined empirically, were efficient germicides, to which property they owed their therapeutic efficacy. Thus exact science discovers new practical truths and furnishes explanation and confirmation of old ones. It also shows wherein lies the fallacy of old errors.

The present decade, thus far, witnesses a radical departure in the principles of the treatment of the germ diseases. The search for purely chemical germ-destroyers has been largely superseded by another line of research. The same bacteriological laboratories which showed us the pathogenic germs are now pointing out to us the natural or biological remedies, for both prevention and cure. These, as thus far developed, can be grouped into the following classes:

1. The introduction of the blood serum of animals known to have a natural immunity or resisting power against the diseases under consideration. This is exemplified in the use of blood of asses, goats and other animals against tuberculosis.

2. The introduction of the blood serum of animals rendered artificially immune by the cultivation of the disease within their system, and the consequent development of the anti-toxine elaborated by the disease germs themselves This is illustrated in in their life processes. the use of the treatment of diphtheria by antitoxines developed in horses by artificial culture. We refer our readers to the most excellent article of Dr. Verge on this subject in this issue.

3. The introduction of anti toxines derived from the germs of another disease found to be antagonistic to the diseased condition which it is. desired to treat. This is illustrated in the treatment of cancer by erysipelas inoculation, often noticed in our pages.

This is now the field for research, and it is our opinion that it will prove a very productive As has been the case with most other

one.

great new principles in science, it also promises to be a field of active contest and controversy, until the facts, whatever they are, are definitely established. Already the venerable and scholarly Virchow has taken a position as questioning the value of the anti-toxine treatment of diphtheria.

The chemists hint at the possible synthetical construction of substances identical with the anti-toxines, by which these substances may be manufactured in any desired quantity, without the delay and expense of their development bio logically, the use of which will not be attended with the septic dangers which may exist in the organic serums. This would be the grand desideratum to be striven for. It is barely possible that the successful physician of the not far distant future must be a skillful bacteriologist.

In the light of this subject it becomes apparent how important it is that those who are working on purely scientific investigations should be supported in such work by the government. Scientific geniuses are seldom money-makers and hence their work often has to wait until they can stop long enough to obtain means to enable them to go on a few steps further. The results of their work are solely for the benefit of the the general public. So, then, does it not appear that we should have a governmental institution for scientific research, wherein this work could be conducted to the best advantage? We educate our soldiers and marines; why not furnish the means for our public defense against disease?

Castration for Hypertrophy of the Prostate Gland.

In the early days of ovariotomy it was acci. dentally observed that the uterus undergoes a marked degree of atrophy after the removal of the ovaries. Acting upon this discovery, the same operation has been successfully resorted to for the purpose of causing the involution and absorption of fibroid tumors of the uterus. Now, the prostate gland is the male analogue of the uterus, as the testicles are also the male analogue of the ovaries. Reasoning on this line, Prof. J. William White, of the University of Pennsylvania, has devised the operation of the removal of the testicles in old men for the relief

of enlarged prostate, with difficulty of urination. The operation has now been performed many times, with most gratifying success. This is the surgical lesson of the year. We hope no foreign operator will try to deprive Prof. White of the honor of priority in it.

We regret that the Board of Charities of this city has seen fit not to re-elect Dr. Judson Daland as a member of the staff of visiting physicians to the Philadelphia Hospital. Dr. Daland is a hard and conscientious worker, and brings great ability to his work in scientific research and the treatment of his patients. He has given much time and attention to the hospital, and his observations of disease there have enriched medical science. It is to be regretted that a lay Board does not appreciate the value of such observations and research. They benefit medical science, humanity, and the very patients themselves upon whom such observations are made. But a lay Board is apt to consider everything outside of routine treatment as unjustifiable experimentation.

Malaria has for generations been the great perplexity of the medical profession. We have had to study it solely from its clinical manifestations; and our consequent treatment of it has been purely empirical. Dr. Daland has sought, and with gratifying success, to extend our knowledge of its specific cause, the plasmodium malariæ, in the blood. It is to be regretted that a lay Board is unable to appreciate the value of such investigations.

To those of our readers who are investigating any special line of medical research we commend, as a most valuable magazine, The Index Medicus, published by George S. Davis, Detroit, Mich. It gives each month the titles of all the important contributions to medical science all over the world, with brief statement of the contents of the same. This magazine is published for the benefit of medical science and not at all a sa profitable commercial enterprise, as it does not return the cost of publication. It would be a great loss to medical science if it should be allowed to suspend publication for want of appreciation and financial support.

Articles accepted must be contributed to this journal only. The editors are not responsible for views expressed by contributors.

Copy must be received on or before the twelfth of the month for publication in the next month. Unused Manuscript cannot be returned.

Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them Generally, also, a downright fact may be told in a plais way; and we want downright facts at present more thas ything else.—RUSKIN.

Coughs and Colds.-Breast Tumors.-Details in Treatment of Morphine Habit.

Editor MEDICAL WORLD:-The day following Thanksgiving, Christmas, or any such day when people eat all they can hold, is sure to bring a crop of catarrhs, of the nose or bronchi most frequently. A brisk cathartic, with a day's abstinence from food and drink, brings about a speedy cure. It is singular that the laity usually treat such cases with copious libations of hot or cold fluids-precisely the worst thing to be done. I have often brought on a coryza by indulging freely in water, or aborted an attack by abstinence.

For the cough of acute bronchitis, the remedies are opium, ipecacuanha, and the inhalation of steam. The cold compress is an excellent remedy. If the acute symptoms subside, and the cough remains dry and irritating, the remedies are the alkalies and lobelia. There is a peculiarly irritating, dry, hard, laryngeal cough, following la grippe, and this is speedily cured by yerba santa. When a cough has lasted too long, and threatens to become chronic, the iodides should be given, or iodoform. The latter is especially effectual for the cases that look like consumption, but are not-when a pneumonia does not pass cff, but the patient still has fever, cough, purulent or bloody sputa, emaciation, loss of strength, etc., but the microscope shows no bacilli in the sputa. Here is the op portunity for iodoform, gr. j, ter in die, and you realize what a grand remedy it is. Even in true tuberculosis it is of use, relieving the cough and checking the discharge. Sometimes the secretion of mucus is too free, and the patient raises pounds of thin sputa daily. Then the balsams cone into action-copaiba, cubeb, tolu, myrrh, and the volatile oils, such as turpentine, eucalyptus, etc. These are also useful when a ough does not entirely get well, but the mu

When there is a profuse, colliquative flow, a bronchorrhea, in the late stages of phthisis, the lactophosphate of lime is an excellent addition to the above. The compound iron mixture of the pharmacopeia is useful in bronchorrhea, especially in anemic cases.

Sometimes the mucous membrane becomes insensitive, allowing secretions to collect and fill up the bronchi until the symptoms of cyanosis appear, such as sluggishness, blue lips, dusky skin, loose, mucous rales, etc. This is seen in bronchitis and in phthisis in the chronic forms. The stimulating expectorants come into play here the best being sanguinaria, senega, squill, ammonia and serpentaria. They make the patient cough harder, and bring up the secretion, the improvement being marked. They should not be pushed too long, or in too large doses.

When dyspnea is a prominent symptom, the remedies are grindelia robusta (or its alkaloid, aspidospermine), hydrocyanic acid, camphor,. asafetida, the bromides and codeine.

The indications for these drugs are so preciseand distinct that it is singular how universally physicians mix them together in the same prescription, without regard to their effects. We will have opium to soothe the irritated membrane and squill to excite it; ipecac to promote secretion and tolu to check it; spirits of nitrous ether to allay dyspnea, and chloride of ammonium to upset the digestive organs, and a few others chucked in on general principles! Try, in contrast to this, the effect, in acute catarrh, of a little aconitine, emetine and codeine, dissolved in a glass ef water, keeping the room at one heat and moistening the air, with rest of the vocal apparatus, steaming for paroxysms, and a cold compress, and you will not wonder why people like homeopathy.

Codeine is better than morphine for relieving cough, but takes three times the dose.

The best preparation of prussic acid is the oil of bitter almonds. It is of great use in phthisis and all chronic, irritative coughs.

Cannabis indica (a good English extract, not the worthless cannabin), in doses of graint, soothes irritation and secures sleep.

Solanine, a ropine, and its congeners of the mydriatic group, are best suited to dyspneic or asthmatic coughs, when there is no fever, or when the secretion is profuse.

Anemonine, veratrine and aconitine and antimony are useful in acute cough, with fever. Cicutine has been recommended for dyspneic cough, with acute congestion.

Lobeline, apomorphine, and emetine are powerful stimulants to secretion, and are suited to

dry forms, when the secretion is so sticky that it can only be raised after violent efforts.

Hyoscyamine is useful for dry night cough, or for a little hack not noticed so much by the patient as by his friends.

Gelsemium is useful for incessant, convulsive reflex or nervous cough, for that of fever, or for acute laryngitis with burning,

Fetid bronchitis is best treated by turpentine, eucalyptol or myrtol.

I have been asked what cough opiates increase instead of relieving. Edema of the lungs, from disease of the kidneys or of the heart, is aggravated by opium. Dyspnea is often not benefited and may be made worse by opium. Reflex cough, from constipation, etc., may be aggravated by opium.

Bronchorrhea sometimes depends on relaxation of the mucous tissues, when ergotine, strychnine, or digitaline are the best remedies.

Winter cough is chronic catarrh. The bal sams, terpine and eucalyptol, are of value, but climate is the best remedy.

Whenever the cough remains obstinately, the patients becoming reduced in strength, and evireduced in strength, and evidently being unable to throw off the disease and set up the restorative processes, the tonics are required-cod liver oil, tincture of iron, iodide of iron, etc., according to the case.

More than once I have found my cough remedies useless, until I looked in the mouth and found a prolonged uvula, enlarged tonsils, or chronic pharyngitis responsible. Foreign bodies in the ear, obstructed nasal passages, decayed teeth, dilated stomach, fecal impaction and utero-ovarian disease, have been found to be reflex causes of cough.

Breast Tumors.-I have one more case to add to those published in my last letter. A lady had received a blow from her husband on the breast, the result being a small, hard lump. This remained for years without change; then one day it began to enlarge, and in a few months had grown to the size of a small cocoanut. I removed it and the breast entire. The tumor proved to be a large-celled sarcoma, having a cystic appearance, due to the occlusion of the milk ducts. This was one of my earlier operations, and the patient has gone beyond my reach; but when I last heard from her, several years after the operation, there had been no return of the disease.

QI mention this as one more instance of the growth of a tumor at the seat of an injury, ap. parently trifling, and of the danger of leaving such tumors to develop into cancers. "Have

it out," is the only safe advice to give a patient who has a tumor, even if it be quiescent. That in the case described the disease did not recur

and kill the patient, is simply an instance of what is called "dumb luck." It certainly was not good surgery to leave the tumor so long.

My last letter was written from Philadelphia This one hails from Eddy, New Mexico, nearly 3,000 miles away. It is an irrigation country, a desert a few years since now a blooming oasis. Water, that beneficent fairy, has touched the dry, chocolate earth, and transformed it into a garden, covered with the richest crops. Farming is reduced to a certainty here, as regards water supply--it is neither too much or too little. It is a good place to visit, or to send patients who need a dry climate-consumptives, rheumatics, and those who do not bear cold winters well.

Two cases of the morphine habit now in my private hospital illustrate fully the folly of attempting to treat all cases in the same way. One has a feeble, fatty heart, and has been taking cactus ever since he entered, with brucine whenever the circulation flagged, and ammonia when collapse threatened. The other has had a strong, bounding pulse, with some rise of temperature since the morphine was lowered to two grains daily. He has been treated with bromides, veratrine, and low diet, while the former has been systematically fed all his digestive organs will bear. When we reflect that the treatment of these two cases is by precisely antagonistic means, we see how impossible it is to lay down laws for universal application.

One of my recent cases had suffered with pruritus ani. Recollecting the great suffering experienced in a former case by this torment, we expected a similar ordeal. I directed him to apply twice daily a little Goulard's extract, diluted with four parts of water, and he has had no pruritus. WILLIAM F. WAUGH, M.D., 103 State street, Chicago.