of blood for the tests and controls. These objections have prevented many interesting observations being made on humans in health and disease. The writers suggest a modification of the technique which is based upon Wright's method of estimating the opsonic index.

Blood for the tests is obtained either from direct puncture of an arm vein or may be obtained from the ear by pricking deeply with a Hagedorn needle. The blood for the corpuscles is received directly into saltcitrate solution (0.5 per cent sodium citrate, 0.85 per cent sodium chlorid). The blood for serum is received in a small test-tube, slanted and allowed to clot, or glass capsules, six or seven centimeters long may be drawn out into capillaries at the ends and the blood directly run into them. [Abstractor's note: The regulation U-shaped Wright's opsonic blood collecting tubes, made from eight millemeter tubing, are very convenient.] The ends are sealed in a flame, and the serum separated by centrifugalization. In making the serum-corpuscle mixtures, small capillary pipettes fitted with rubber nipples are used. The capillary ends of these pipettes are marked with blue pencil, denoting the proportions of the elements of the test. An air bubble may be used to separate the ingredients, and thus the entire test can be carried out in one tube, with excellent facilities for proper mixing and observation. A tumbler of sand is suggested for holding the pipettes (after sealing) during their period of incubation. The writers suggest the serum be used within twelve hours after obtaining the blood. After two hours in the incubator the cells have usually separated from the mixture in the pipette and may be seen as a thin layer in the capillary tube, or if hemolysis has taken place, the laking can be readily made out above the cell debris. In doubtful cases, placing the pipettes at ice-box temperature from twelve to twenty-four hours facilitates the interpretation of the test. Agglutination, usually prompt, can be well observed in the capillary tubes, by clumping and sedimentation of the massed red cells.

The writers have carried out the method detailed along with tests manipulated by the methods of Weil, Crile and others and report identical results.

BUCKWHEAT POISONING.

SMITH (The Archives of Internal Medicine, Volume III, Number IV) reviews the history, chemistry, symptomatology and treatment of buckwheat poisoning (fagopyrismus) in detail and reports a case in man. The cases are common in animals, and appear to be most prevalent when the buckwheat plant has been eaten while in bloom. The poisoning may occur, however, when animals have been fed grain, bran, chaff, straw or stubble. Animals seem to acquire the malady less frequently when they have been protected from sunlight.

There appear to be many theories as to the causative factors entering into the production of buckwheat poisoning. It has been stated fagopyrismus is primarily a local disorder of the unpigmented skin due to the

disturbing action of fungi that live on buckwheat. or that it is caused by the poisonous products of these parasites. It has also been advanced that the disease is caused by the intestinal absorption of toxic substances, which are generated in buckwheat either as result of bacterial change, or because of peculiar teluric conditions. It is argued that these bodies become active only under the chemical influence of the sun's rays and providing there is no skin pigmentary lining to act as barrier. Smith calls attention to the fact that phyloporphyrin, a derivative of chlorophyl, resembles such hematin derivatives as hematoporphyrin and mesorphyrin, particularly with regard to its absorption spectrum. When phyloporphyrin and hematin are submitted to reduction with concentrated hydriodic acid, hemopyrrol results, and this is converted into hydrobilirubin by the action of sunlight. When bile acts on red cells in the presence of sunlight, prompt hemolysis results.

In man the symptoms of buckwheat poisoning are restlessness, dryness of the throat, nausea, rapid pulse, dilated pupils and intense thirst. In Smith's case there were great injection of the conjunctivæ, retching, air hunger, swelling of the face with redness, feeling of heat without temperature, intense itching, and "lips knotty with hives." The symptoms rapidly followed the eating of a piece of buckwheat cake. Other people who had eaten of the same cakes were not affected in any way. Later attacks were experienced whenever the patient ate of anything prepared from buckwheat flour. In some of these the face, tongue, neck, shoulders, and hands were swollen, red and itched intensely. There was evidently similar erythema of deeper mucous surfaces, inasmuch as the patient coughed continuously, experienced great difficulty in breathing, and saliva dripped from his mouth. Experimentally, many of the symptoms were produced when an infusion of buckwheat was instilled into the conjunctiva or rubbed on the scarified skin. Ingestion of buckwheat powder combinations by mouth also produced rapid reaction.

The author's experiments are very fascinating and would appear to demonstrate that in addition to poisonous substances which may or may not exist in buckwheat, the question of idiosyncrasy is a considerable factor in the production of the "poisoning."

THERAPEUTICS.

DELOS LEONARD PARKER, PH. B., M. D.

ADJUNCT PROFESSOR OF MATERIA MEDICA IN THE DETROIT COLLEGE OF MEDICINE.

THE USE OF OIL OF CLOVES (OLEUM CARYOPHYLLI) IN PULMONARY TUBERCULOSIS.

LANDIS and HARTZ, of Philadelphia (Therapeutic Gazette, June, 1909) discuss advanced stages of pulmonary tuberculosis in which cavities are formed, and in which severe paroxysms of coughing and excesive amounts of sputum are the most prominent symptoms.

In this class of cases creosote and its congeners, or opium in one form or another, are frequently employed, but it must be confessed with indifferent results.

In the tuberculosis wards of the Philadelphia General Hospital, a majority of the tuberculosis patients are in advanced stages of the disease, and in a considerable number of these hopelessly diseased patients cough and expectoration are the symptoms demanding the most attention. Not getting satisfactory results from the ordinary remedies, Doctors Landis and Hartz were led to try the effect of oil of cloves. The administration was limited to the internal method.

Patients presenting the following symptoms were selected: They had severe paroxysms of coughing, which finally ended in the expectoration of large quantities of thick, lumpy, greenish-yellow sputum. These cases, without exception, had been treated with various cough mixtures, and in some instances large doses of codeine, or morphine had been employed without giving relief.

In carrying out the treatment effort was made to avoid the effect of mental suggestion. The nurse was instructed to record the frequency of the paroxysms of coughing, and the amount of sputum in twenty-four hours. The statements of the patients was always compared with the observations of the nurses, as to the abatement of the cough, and the reduction in the amount of sputum.

In those cases in which the drug acted favorably, the cough abated in severity and frequency and the amount of sputum was greatly reduced, in some instances from three or four boxfulls to one or even half a boxfull in twenty-four hours. In addition, the character of the sputum changed, becoming less lumpy in appearance and more like ordinary saliva. The sputum was furthermore expectorated with little or no difficulty. In a few instances there was a general improvement in the condition of the patient, which was ascribed chiefly to their obtaining more sleep and retaining their food, rather than to any direct effect of the oil of cloves. The appetite may also have been stimulated by the oil of cloves.

In addition to the tuberculosis cases, a case of bronchiectasis of five years' standing was greatly benefited by the oil of cloves. The paroxysms of coughing were lessened in severity and the amount expectorated was not only diminished in quantity but was rendered less fetid than it had been.

The success obtained in the cases reported led to the employment of the drug in patients having a severe cough, but in whom the amount of sputum expectorated was not marked. The results in these cases were uniformly bad. The cough became tighter and the patients complained of a feeling of constriction across the chest.

Nearly all those taking the drug complained of a slight burning sensation in the mouth and esophagus after taking the drug. This lasted but a few minutes, and after a few days was not complained of. Two patients were found who were unable to take the drug, as it was immediately ejected.

Of fifty cases treated, thirty had severe cough with much expectoration, while of the remaining twenty the amount of sputum was slight and the cough for the most part unproductive. Twenty-four of the thirty patients with large amount of sputum were distinctly benefited. Those with an unproductive cough were not helped and, as a rule, were made worse by the drug. Given internally, oil of cloves may be administered in dosage of from three to five minims in half a glass of milk or in capsules. A number of combinations were tried in the attempt to obtain a pleasing pharmaceutic preparation. The following was the most satisfactory found:

R. Olei Caryophylli,

Syrupi Senega, of each, two drams.

Ext. Glycyrrhizæ, fluid, one and one-half ounces.
Aquæ Destillatæ, q.s., three ounces.

Misce. Signa: Teaspoonful three time a day after meals.

The drug may be administered hypodermically, in a daily dose of five minims in thirty minims of pure olive oil.

Internal administration may be continued from ten days to three weeks. If no benefit results in ten days, use may be abandoned. In all cases it seems well to discontinue its use at the end of two or three weeks. If the expectoration again increases, the drug may be again resumed.

PATHOLOGY.

ALDRED SCOTT WARTHIN, PH. D., M. D.

PROFESSOR OF PATHOLOGY AND DIRECTOR OF THE PATHOLOGICAL LABORATORY AT THE
UNIVERSITY OF MICHIGAN.

PLINN FREDERICK MORSE, B. A., M. D.

INSTRUCTOR IN PATHOLOGY IN THE UNIVERSITY OF MICHIGAN.

EXPERIENCES TO DATE IN THE CULTIVATION OF THE SPIROCHAETE PALLIDA.

SCHERESCHEWSKY, of the dermatologic clinic of the University of Breslau, in a paper (Deutsche medizinische Wochenschrift, Number XXXVIII, pages 1652-1654, September 23, 1909) read at the Sixteenth International Congress of Medicine at Budapest, refers to Mühlens' success in cultivating the spirochete dentium and to the fruitless efforts of all investigators to cultivate all other kinds of spirochetes on artificial media if the collodion-sac culture of Levaditi and the complex medium of Todd for the spirochete dentium be excepted. He quotes Mühlens as saying that the negative results of endeavors to cultivate the spirochete pallida show that the conditions for growth of the spirochete pallida are wholly different from those of the morphologically similar spirochete dentium. Levaditi is also quoted as saying that the cultivation of the pallida in vitro is impossible.

The author then states that he has not shared these negative results nor held these negative views of other workers, but that he has been able to

cultivate a spirochete from syphilitic material, first on ascitic fluid and later on horse serum, that in no respect differed morphologically, either in the stained or fresh preparations, from the spirochete pallida. Doctor Neisser, Doctor Beuck and Doctor Pfeiffer, as well as the gentlemen at the institute for infectious diseases at Berlin, examined his preparations and agreed that morphologically these cultural spirochetes were identical with the pallida. These cultures could be reinoculated at will in periods up to ten days, from tube to tube. His work was confirmed by Mühlens as regards the possibility of cultivation and morphological identity of the spirochete with pallida. Levaditi and Shanesko were able to grow these spirochetes from syphilitic material but deny their identity with the pallida on account of certain differences in staining reaction and lack of pathogenicity toward animals. These investigators therefore gave the name spirochete balantidis to this cultivated organism.

Schereschewsky does not discuss these objections in his paper but says that he holds them to be unimportant. The writer lays great stress on the importance of the morphological identity of his spirochete with that of true pallida as proving that they are one and the same, and says that if we deny our ability to always recognize pallida when we see it we deny not only its importance as a diagnostic measure in suspected cases of syphilis but cast doubt on its etiological relation to the disease itself. He mentions certain interesting peculiarities in his cultures, analogous to those observed by Mühlens in the case of the spirochete dentium, namely, that for the first few generations after planting, the spirochete refringens was almost exclusively present, and was gradually replaced by the true pallida. He offers the explanation that this is either due to there being a contamination of the culture with refringens which dies out and leaves the more hardy pallida in the field, or that it is a case of metamorphosis of the refringens to the pallida form. He offers no opinion as to which of these suppositions is the correct one.

The author attempted to prove the identity of his spirochete by four methods, namely: the agglutination reaction; the precipitin test; the complement binding phenomenon of Bordet Gengou, and animal inoculation.

The agglutination reaction was negative, being especially difficult to work with because of the tendency of the spirochetes to agglutinate spontaneously in the salt solution.

The precipitin reaction was negative. A culture filtrate had no effect on luetic sera taken from patients in many different stages of the disease. The complement-binding phenomenon gave positive results but was not conclusive because the possibility of the medium containing antigen bodies (horse serum, et cetera) could not be ruled out.

Animal inoculation was also negative although interesting, in that on a number of apes small sores appeared after twelve to fifteen days at the site of inoculation, and after all primary reaction had subsided. These lesions were not typical of syphilis in any respect nor was the spirochete