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spring, but this can only be definitely settled after many years of experience.

The Aseptic Ward, which has been added to the London Temperance Hospital, has been formally declared open. Dr. Collins, chairman of the London County Council, is a member of the surgical staff, and explained that the ward had been added with the double purpose of being an operating theater and a quiet resort for the reception of a patient in the earlier stages of recovery. The furniture is entirely of metal. A speaker at the opening ceremony remarked that it had been said that teetotalers were the greatest evil that drink had produced, but he thought they had at least founded one of the finest hospitals in London.

At the quarterly meeting of the Society for the Study of Inebriety, Mr. W. L. Brown gave an account of ancient so-called remedies for intoxication, but said the true cure was the treatment of the inebriate as a diseased individual, with involuntary curative restraint.

Professor Kanthack, of Cambridge University, has, at the request of the Truro Corporation, reported upon samples of oysters taken from the foreshore of the river Fal. It was found that there was evidence of sewage contamination, but no typhoid fever germs were discovered.

The hygienic condition of the French army is, according to the statistics for 1895 just published, highly unsatisfactory. The general mortality is rising from year to year. In 1893 it was 6.19; in 1894, 6.26, and in 1895, 6.85 per 1,000 soldiers.

LONDON, Jan. 1898.

SERUM DIAGNOSIS OF TYPHOID FEVER.–Patella ( Atti e Rendiconti dell Acad. Med.-Chir. di Perugia, vol. ix, f. 2), writing on the above subject, confirms the favorable experience of others with regard to Widal's reaction in the differential diagnosis of typhoid. As with other observers, so with the author agglutinative action was noticed in diseases that were not typhoid; for example, in a case of ulcerative endocarditis the reaction was observed; still, on the whole, he believes the test is a valid one, and likely to prove more useful in future than at present. Whether the agglutinative power is a reaction of infection or of immunity seems to be as yet an open question; in any case it is associated with the globulin substances, and has nothing to do with serum albumin. It seems doubtful whether any prognostic value can be attached to the intensity of Widal's reaction in relation to the gravity of the disease. In two thirds of the cases of typhoid Widal's reaction was observed in the first week in a dilution of one in ten, at reaction which was not observed in more than two per cent of non-typhoid cases when the serum was so diluted. Later on in the disease reaction is positive with dilutions even up to one in two thousand, which never happens in other diseases.-British Medical Journal.

Abstracts and Selections.

LUMBAR PUNCTURE.-V. Ranke (Munch. med. Woch., September 21, 1897.) discusses the value of lumbar puncture in tuberculous meningitis. He has employed it in twenty-five cases, including nineteen of this form of meningitis. The author observes that in no case as yet has the puncture produced a cure. In Freyhan's atypical case the recovery could not be shown to be due to the puncture. A fatal result occurred in all the author's nineteen cases of tuberculous meningitis. V. Ranke gives instances in which a temporary improvement followed upon the puncture, but in most cases there was no change in the condition of the patient. It would appear that such improvement is only seen in the early stages of the disease, when the pressure has not lasted long. The author has never seen any improvement in the optic neuritis. It must be remembered that the symptoms of tuberculous meningitis are liable to great variation. As a rule the diagnosis of this disease is easy, but in some few cases it may be impossible, and it is in these cases that a positive result obtained by spinal puncture may be of diagnostic value. As with many other observers, the author found the number of tubercle bacilli present in the fluid to be small in numbers. He concludes that lumbar puncture can only be of very limited diagnostic value in tuberculous meningitis. The differential diagnosis between it and the meningitis consecutive to ear disease has not always been made easy by spinal puncture. In tuberculous meningitis the fluid drawn off is clear, usually colorless, but it may be very slightly green or yellow. The specific gravity was about 1010, and the amount of albumin i to 1.5 pro mille. Traces of sugar were present. The amount of fluid drawn off was usually from 20 to 30, and the pressure high, amounting to 160 mm. to 300. mm. water. In the author's cases no harm of any kind was produced by the puncture.-British Medical Journal.


The Toxin OF THE GONOCOCCUS. --The Annales de l'Institut Pasteur for August, 1897, contains the results of an interesting series of experiments with the toxin of the gonococcus. It produces local and general phenomena if injected experimentally, with pronounced phlogogenic properties if injected into the eye or the pleura of the rabbit, while no effect follows its application on the mucous membrane of the conjunctiva or urethra. On the other hand, it produces in man a decided reaction in the urethra, transient but acute while it lasts. The urethra is not immunized by the process, as the same experience was repeated five times in succession. This reaction of the human urethra is special to the gonococcus toxin. Other toxins tested failed to produce any such result. Certain

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facts indicate that the toxin is located in the body of the coccus and liberated as it dies. It will stand heat to 70 degrees C., and is precipitated by alcohol. Attempts at immunization were successful with rabbits and goats. The serum of goats injected with increasing amounts of the toxin during the course of a year, rendered rabbits immune to the phlogogenic action of the toxin, which can then be injected into the eye and pleura without reaction. These facts have not yet been applied to therapeutics, but De Christmas hopes to obtain in time a serum powerful enough to arrest the progress of local gonorrhea and effect favorably the general phenomena caused by its toxin.-Presse Med., November 27th.

The RADICAL CURE OF HERNIA IN INFANCY.-Froelich (Rev. de Chir., No. II, Supplement, 1897,) at a recent session of the Congres Francais d, Chirurgie, discussed the indications of the radical cure of inguinal hernia in infants, and described his method of operating in such cases. This surgeon holds that in children under two years of age inguinal hernia will usually be cured by the use of a suitable truss. Beyond this age spontaneous cure is an exceptional event, and an operation for radical cure is therefore indicated. In early life, if a hernia increases in size in spite of the application of a good truss, an operation should be performed, however young may be the subject. Such treatment, which is almost quite free from risk, will not only relieve the child of a permanent infirmity, but also obviate the physiological failure likely to be caused by a large hernia. The mortality, it is stated, is about four per cent and the relapses six per cent. The operation performed by Froelich consists in simple ligature of the neck of the sac, which is retained intact and without any dissection from the scrotal tissues, and in careful suture of the abdominal wall. In the discussion on this paper Broca expressed his concurrence with regard to the indications for surgical treatment in young subjects, but at the same time held that it was advisable to deal more freely with the sac. In children as in adults there is no risk of peritonitis, and therefore, except with regard to the save ing of time, no advantage can be gained by refraining from opening and removing the sac.-British Medical Journal.

SPITTING IN THE STREET-CARS.—The observance of the prohibition of the Boston Board of Health and the boards of some of the neighboring towns against spitting in the street-cars seems of late to have been somewhat lax. Before resort is had to more stringent measures for the enforcement of the rule, the authorities of the Boston Street Railway Company propose trying the effect of furnishing the conductors with pads of slips on which are printed the regulations of the Board of Health. To every offender and on the occasion of each offense against the rule the conductors are enjoined to politely furnish one of these slips. We would suggest that the conductors be also provided with a basket of destructible spit cups, and a bottle of antiseptic solution, to be furnished together with the slip.Boston Medical and Surgical Journal.

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The introduction of any new narcotic or stimulant into the pharmacopeia of the civilized world, whatever may be its beneficient uses in the hands of the physician and surgeon, must be considered as a doubtful blessing by the true philanthropist. For the inefficiency of our laws regulating the sale of poisons, and the facility with which a patent on any sort of nostrum may be obtained, with the appropriation and prostitution by the patent medicine man of every efficient medicament which science brings to light, make drug habitues by the thousands, and threaten to check the higher evolution of mankind.

Some such reflections are necessarily awakened when we contemplate the advent and progress of the coca erythroxylon, and make us wish that it had continued a sacred secret and religious mystery among the South American aborigines, as it was before the Spanish invasion and for a long time after. For the Spaniards at first regarded the sacred plant as an abomination and of “diabolical origin and virtues;” and one is inclined to think that their rating of it was not inappropriate, when one sees what a devil it has proved to be since they turned it loose to scourge mankind.

The cocaine habit bids fair to become as firmly fixed upon civilization as the opium, tobacco, and alcohol habits, with far greater damage to the consumer. Its use by mouth or by the hypodermic method to

ease pain, or exalt the drooping spirits, has wrought untold mischief; but, as is more evident daily, its most common avenue of entrance into the system is the nose, where through the vehicle of quack snuffs (for the cure of colds, catarrhs, etc.) it is exerting its pernicious influence upon a very large number of victims. And when we reflect that these victims are victims in the fullest sense of the word-never suspecting till too late that they are being brought under the influence of a subtle and enslaving drug—we can but view with indignation a system of legislation which will permit quackery and its lust for gain to commit such an outrage upon society.

The following letter to the Boston Medical and Surgical Journal, 3d inst., by Dr. Daniel D. Gilbert, of Boston, Mass., cites a case to the point. But reports of similar cases might be collected by thousands.

Dr. Gilbert writes:

Will you kindly allow me the use of your columns to briefly report the salient features of one case where a promising young life has been greatly injured, if not totally wrecked, and a family circle brought to grief by the unrestricted sale of nostrums containing cocaine.

About two years ago, while away at boarding-school, a young man from one of the families who look to me for medical advice, together with a chum of his, sought relief from a fancied or real catarrh in the use of “Birney's Catarrh Snuff,” containing two and one-half per cent of cocaine. The result was that, when the case was first brought to my knowledge and the full discovery of the state of affairs was made known, about three months ago, the young man was using from three to six bottles of this snuff daily, and was a confirmed victim of the cocaine habit. He had run up bills for this snuff to the total of about $600 at various drug stores where apparently the greed of gain, in some cases at least, and in others ignorance that the apparently harmless nostrum contained a powerful poison, prevented the dealers from taking steps to stop the young man's ruinous career. The accounts, without any notice being given to the young man's family, were allowed to run along for several months, and in one amounted to over $100, while another footed up between $80 and $90.

The young man is now away from home, at an expense of $50 per week, under treatment which must be continued for a period of five months before he can be trusted alone, and even then there is grave doubt in regard to the permanency of the cure.

I am told that there is no law to prevent the unrestricted sale of this most insidious poison, cocaine. It seems proper that new legislation should be obtained for the protection of the public. The matter will be brought before the Massachusetts Medical Society at the next meeting of the Councillors.


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